PARKOUR WORKSHOPS- REGISTRATION FORM
PARKOUR WORKSHOPS- REGISTRATION FORM
PARKOUR WORKSHOPS- REGISTRATION FORM
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<strong>PARKOUR</strong> <strong>WORKSHOPS</strong>- <strong>REGISTRATION</strong> <strong>FORM</strong>DateJuly 17/18/19PARTICIPANT’S NAME: _________________________________AGE: __________PHONE NUMBER:EMAIL:Do you want The Youth Shed to send you information about upcoming events? YNWHICH <strong>WORKSHOPS</strong> WILL YOU BE PARTICIPATING IN?JULY 17 – 3:00PM –6:00PMINTRODUCTION TO<strong>PARKOUR</strong>,SET UP DAY,HANG OUTJULY 18 – 10:00AM – 2PMBASIC / INTERMEDIATESKILLS AND TRAININGJULY 19 – 10:00AM – 2PMINTERMEDIATE ANDADVANCED TRAININGDO YOU HAVE ANY MEDICAL CONDITIONS/PHYSICAL CONDITIONS/ALLERGIESTHAT MAY AFFECT YOUR ABILITY TO PARTICIPATE IN THIS PROGRAM? IF YES,PLEASE DETAIL BELOW.I give permission for photographs of myself to be used in Council and Sponsors promotionalmaterial including website, social media, publications and media releases.Signature______________________Date_______________Parent / guardian consent (if applicant is 11-18 years of age)I give permission for my son / daughter to participate in the Rock and Deck WorkshopI give permission for photographs of my son/daughter to be used in Council and Sponsorspromotional material including website, social media, publications and media releases.Parent / guardian’s name: ____________________________________________Signature: ______________________Emergency contact phone numbers: ________________________________________ONCE YOU HAVE COMPLETED THIS <strong>FORM</strong> PLEASE EITHER:Email to: connor.mcleod@roebourne.wa.gov.auPost to: The Youth Shed, PO Box 219, Karratha WA 6714; orDrop off at: The Youth Shed, Hillview Road, Karratha WAPage 1 of 2
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