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FLING Physical Theatre

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Parent/ Gaurdian Details (Account Holder)

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Parent/ Gaurdian Details

First name
Last name
Address 1
Address 2
Suburb
State
Postcode
Billing address 1
Billing address 2
Billing suburb
Billing suburb
Billing postcode
Home phone
Work phone
Mobile
Mobile #2
Email
Email #2
Alternate Contact Name
Alternate contact number
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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

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Order Details

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