Online Art School Holiday Programme

Registration Form

Week One: Theme - It's a Springtime Adventure
When: Tuesday 4 October
Time: 10.30am to 12.00pm

Week Two: Theme - Favourite Animals and Me
When: Tuesday 11 October
Time: 10.30am to 12.00pm

The cost of both sessions is $5.00 and this includes art supplies that will be sent to you.

Account Number: 12-3113-0000916-00
Reference: HolProg & your name.
Please pay registration fee as soon as possible to secure your place.

CHILD'S DETAILS

First Name *

Surname *

Date of Birth *

Address *

To be eligible the child must have a physical disability - please state your child's disability *

First-time contact please attach a diagnosis letter

(file size 5MB max)

Ethnicity *

Sibling names and age attending

PARENT/CAREGIVER DETAILS:

First Name

Surname

Phone / Mobile

Email *

Relationship to Child *

PLEASE TICK THE ACTIVITY YOU WISH TO ATTEND

LOCATION - Online

It's a springtime adventure

Tuesday 4 October 2022 : 10.30am to 12.00 noon

Yes

Favourite animals and me

Tuesday 11 October 2022 : 10.30am to 12.00 noon

Yes

A $5.00 non-Refundable Registration Fee is required per child for both or one session

This can be deposited into Account Number: 12-3113-0000916-00, Reference: HolProg & your name

Upon receipt of this form the Wilson Home Trust will confirm your acceptance on the course via email