Registration Form: Stage 6 Study Morning

Program date: Saturday 8 May, 9am – 12pm
Registrations close: Monday 3 May, 5 pm
Students: Visual Art, years 11 – 12 / Stage 6
Cost: Free (Registration essential)

Individual students are asked to complete the following registration form by Monday 3 May to join this study morning at Campbelltown Arts Centre.

This is a FREE program, but registrations are essential and limited places available.

C-A-C will contact you and your parent/carer by Tuesday 4 May to confirm your registration.

Enquiries & more info:
Feel free to contact Edwina Hill, Education Officer either over the phone, email or face to face, for more information or to discuss different ways to apply.

Edwina Hill, Education Officer
(02) 4645 4298
[email protected]

Student Details

Name*

First

Last

School

Grade

Are you an Aboriginal and Torres Strait Islander descendent?

Yes

What is your cultural background?

Suburb

Phone

Area Code

Phone Number

Email*

Please state your dietary requirements

How did you hear about this program? (Please include teacher’s name if applicable)

Student Registration Questions

What areas of the Visual Art course would like to improve on? What do you find most difficult or do you have any questions?

How would you like to use your creative arts skills in future? (eg. career, study, enjoyment, projects you’d like to undertake) *

Parent/Carer to Complete

Name *

First

Last

Phone *

Area Code

Phone Number

Emergency Contact Details (if different to above)

Name

First

Last

Phone

Area Code

Phone Number

Photo Permission*

Grant

Deny

Permission to Campbelltown City Council c/- Campbelltown Arts Centre to use the image and likeness of my child as outlined below:

• Recordings and images from this program may be edited and used to publicise and promote Campbelltown Arts Centre, or as part of reporting requirements for funding.
• Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of participants (including Your Child) for use in materials that include, but may not be limited to, printed materials such as brochures and newsletters, videos, and digital images such as those on the Campbelltown City Council and Campbelltown Arts Centre website, and social platforms.
• This permission applies to learning programs conducted by C-A-C. I acknowledge that if at any stage I no longer wish for My Child’s images to be used, I will notify C-A-C in writing via email to [email protected]

Covid-19 safety measures
Please read the following and discuss with your child; please speak to us if you have any queries.

• All visitors to Campbelltown Arts Centre must sign in on arrival
• All participants will be briefed on Covid-19 safety measures at the start of the program. Measures include health & hygiene practices, and physical distancing.
• No one should visit the Arts Centre if they have had  flu- like symptoms, or have been in contact with someone who has been confirmed to have Covid-19 in the last 14 days

DISCLAIMER:
The personal information provided on this application form will be used and disclosed by Campbelltown Arts Centre for general administration and communication, or for any purpose required or permitted by law. This information will be held securely and disposed of when no longer needed.