12 Hour Theatre Program Expression Of Interest
Name *
Your answer
Age *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Email (Parent/Guardian's if under 18) *
Your answer
Anything we should know about? This may include medical conditions, allergies, diagnosed behavioural/cognitive conditions or any injuries. *
Please note: if Participant has an Anaphylaxis Action Plan or an Asthma Action Plan please email a copy to programs@canberrayouththeatre.com.au
Your answer
Emergency Contact Name: *
Your answer
Relationship to you: *
Your answer
Phone Number *
Your answer
I am available for Saturday 28 March, 9am to 9pm. I understand that I/my young artist needs to be available for the full 12 hours of this project *
Required
Submit
Never submit passwords through Google Forms.
This form was created inside of Canberra Youth Theatre Company. Report Abuse