Registration Form: Stage 6 Study Morning

Program date: Saturday 4 March 9am – 2pm
Registrations close: Thursday 2 March, 5pm
Students: Visual Arts, Years 11 – 12 / Stage 6
Cost: Free (Registration essential)

Individual students are asked to complete the following registration form by Thursday 2 March 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 Friday 3 March to confirm your registration. 

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

Samantha Relihan, Acting Education Officer  
(02) 4645 3878 
[email protected]          



Student Details
Are you an Aboriginal and Torres Strait Islander descendent?
What is your cultural background?
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 *
Phone *

Emergency Contact Details (if different to above)

Photo Permission*

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 have their name marked off on arrival with the C-A-C team
• No one should visit the Arts Centre if they have had  flu- like symptoms.
• Hand sanitiser will be available in all workshop spaces 
Students are welcome to wear masks if they feel more comfortable during the session

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.