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FLING Physical Theatre

Class Registration

Parent/ Gaurdian Details (Account Holder)


Student/ Attendee Details

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Class Details

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Booking details

Parent/ Gaurdian Details

First name
Last name
Address 1
Address 2
Billing address 1
Billing address 2
Billing suburb
Billing suburb
Billing postcode
Home phone
Work phone
Mobile #2
Email #2
Alternate Contact Name
Alternate contact number
Volunteer Support
How did you hear about us?
I have ambulance cover

Media Release

I give consent for photgraphc and video, images, voice or written quotes being recorded of my child and I release these documents to be used in newspaper, radio, television, website and social media for the purpose of FLING Physical Theatre publicity or posters

Medical Permission

I Give permission for basic first aid to be given to the student if needed and if necessary for medical assistance to be called

Email Options

Do you wish to receive marketing-related emails from FLING Physical Theatre?

Order Details

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Total due:
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Card Details