Returning student form

Name *

First Name

Last Name

Phone *

(###)

###

####

Payment information *

If you have booked in via the website your deposit will be subtracted from your class fees. If you have pre-paid for the full term, thank you! Select - I’ve paid in full. Please ensure payments are made prior to each class. Chat to Cassie at the start of the lesson for cash or card payments. Direct deposit payment details - BSB: 734655 Account: 640503 reference: your name - art class

Cash/card

Direct deposit

I’ve paid in full

Emergency contact name *

First Name

Last Name

Emergency contact number *

(###)

###

####

Photography and media release consent *

I consent/do not consent to being photographed or filmed during the class for promotional purposes. These images may be used in promotional material, including but not limited to social media platforms.

I consent

I do not consent