The Arts Centre Melbourne

New Participant

Is this registration for a person over 18 years?

Yes - Over 18

Child's date of birth

Medical Information

Does the participant have any medical history or allergies we need to know about?

Yes
No

Does the participant have any medical conditions or disability which may affect safe participation?

Yes
No

Does the participant take any medication we need to know about in case of an emergency?

Yes
No

Does the participant have any additional needs program staff need to be aware of?

Yes
No

Other details

Has your child participated in a Melton Learning Directory program before?

Yes
No

What is your child's gender?

Male
Female
Prefer not to say

Do you speak any language other than English at home?

Yes
No

Do you identify as Aboriginal or Torres Strait Islander?

Yes
No

Melton City Council will not be responsible for any loss, damage or injury to my person or property. Information on this form will be kept private and used only to help provide access to better services in the community.

I Agree

Where

About this location

Accessibility

What's on The Arts Centre Melbourne

Other details

Other details