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Ruse Public School/ATYP Drama Workshops Registration Form
Booking Form for DET Pilot Program with Ruse Public School and Australian Theatre for Young People
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Email
*
Your email
Parent First Name
Your answer
Parent Last Name
Your answer
Student First Name
Your answer
Student Last Name
Your answer
Which class will your child be attending?
*
Choose
MONDAYS 3.30-4.45pm (K-2)
MONDAYS 3.30-4.45pm (YEAR 3-4)
MONDAYS 3.30-4.45pm (YEAR 5-6)
Parent Email
Your answer
Parent Telephone
Your answer
Please provide the name/s of the authorised person/s who are authorised to pick up your child at the completion of the activity
Your answer
Student Gender
Your answer
Student Pronouns (For example: she/her, he/him, they/them)
Your answer
Does the student have any medical conditions or physical access requirements?
Yes
No
Clear selection
If yes please list information
Your answer
Does the participant have any neurodivergence? (Autism, AD(H)D, Dyslexia, Tourette’s)
Yes
No
Clear selection
If yes, is there any specific information you can provide to support the students' inclusion?
Your answer
Does the student identify as either
Choose
Culturally And Linguistically Diverse
Aboriginal and/or Torres Strait Islander
Neither
Is the student up to date with COVID-19 vaccinations?
Yes
No
Prefer not to say
Clear selection
Other Emergency Contact First Name
Your answer
Other Emergency Contact Last Name
Your answer
Other Emergency Contact Phone
Your answer
Other Emergency Contact Relationship To Student
Your answer
A copy of your responses will be emailed to the address you provided.
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