Monday Mentoring Enrolment

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Monday Mentoring Enrolment

* Indicates required field

First and last name of student. *

First

Last

Please complete one form per student enroling.

Student's Date of Birth *

Student's Current Age *

Parent Contact Name *

Parent Contact Email *

Parent phone number *

Second contact name *

Second contact number *

Do you give permission for your child to be in class photos? *

Yes - artworks and class photos Yes - artwork only No

Would you like information about future classes? *

Yes No

Is the student attending with a friend? *

Yes No Maybe

Friends name *

Does the student have any allergies or learning difficulties that are relevant to their participation in the class? *

Yes No

If yes please provide details and management strategies below. *

Further comments or questions *

Submit

HEPWORTH STUDIOS at the Woodford Academy
90 - 92 Great Western Highway Woodford, 2778, NSW, Australia.
[email protected]
0416 110 675

Hepworth Studios is located within the Ngurra (Country) of the Dharug and Gundungurra peoples. We pay respect to Elders both past, present and emerging while recognising the strength, capacity and resilience of Aboriginal and Torres Strait Islander people in the Blue Mountains region.

Home
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