Kaarla Wirren Fire Arts workshops enrolment form

Southern Edge Arts

Kaarla Wirren Workshop - Fire Arts for 16 - 27 year olds
This enrolment is for the Kaarla Wirren Fire Arts Workshops

Click on one of the below images to go to our other available Kaarla Wirren workshops.
KAARLA WIRREN FIRE ARTS ENROLMENT

For 16 to 27 year olds
Number of Participants to Enrol
This enrolment is for Kaarla Wirren - FIRE ARTS
PARTICIPANT ENROLMENT DETAILS
Participant 1 Name*

First NameLast Name
Participant 1 Birth Date*

DayMonthYear
She/HerHe/HimThey/ThemPrefer not to sayOther
Relevant participant 1 Medical / Behavioural information
I consent
Participant 1 Contact Details
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

Participant 2 Name*

First NameLast Name
Participant 2 Birth Date*

DayMonthYear
She/HerHe/HimThey/ThemPrefer not to sayOther
Relevant participant 2 Medical / Behavioural information
I consent
Participant 2 Contact Details

If same details as Participant 1 please indicate 'same as participant 1' in the option below
YesNo
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

EMERGENCY CONTACT DETAILS
Parent / Guardian or Emergency Contact Details

For under 18, please provide Parent/ Guardian details. For 18yrs+ please provide Emergency Contact details
Parent Guardian or Emergency Contact Name*

First NameLast Name
Relationship to participant(s)*
Mobile Number*
Format: 0000-000-000.
E-mail*
example@example.com
Yes pleaseNot at this time
SECONDARY PARENT / GUARDIAN OR EMERGENCY CONTACT
Secondary Parent Guardian or Emergency Contact Name

First NameLast Name
Relationship to participant(s)
Mobile Number
Format: 0000-000-000.
E-mail
example@example.com
Yes pleaseNot at this time

SEA MEMBERSHIP
SEA is a membership-based organisation. All members are required to pay a yearly membership fee and complete a membership form annually.

ANNUAL MEMBERSHIP FEE of $20 ($15 for additional family members) each calendar year is due at time of enrolment.

Southern Edge Arts (SEA) members are entitled to voting privileges at our Annual General Meeting each year. Parents/guardians may elect to vote on behalf of their minor. By signing up as a member of SEA you are agreeing to:

- Adhere to our Constitution (available to download on our website).

- Adhere to our member Code of Conduct and Policies.

- Your email address being added to our Newsletter database (you can unsubscribe at any time).

- Photos or video footage being taken of members and used on the SEA website, Youtube, Vimeo, Facebook and other third party websites to promote the work of SEA and our funding bodies unless opted out above.
Aboriginal and/or Torres Strait IslanderPerson from a culturally diverse backgroundPerson with additional needs to support your inclusion
To Sign Print Parent/Guardian Full Name or Your Name if 18+years*

First NameLast Name
Date Signed*

MonthDayYear
Date

KAARLA WIRREN FIRE ARTS WORKSHOPS ENROLMENT

All participants must be SEA Members for insurance purposes. All participants must be 16 - 27 years old

MEMBERSHIP PAYMENT AND ENROLMENTS

FIRST MEMBERSHIP

to be paid each calendar year

$20.00AUD Quantity

ADDITIONAL FAMILY MEMBERSHIP

$15.00AUD Quantity

I'M A CURRENT 2026 MEMBER

$ FreeAUD Quantity

FIRE ARTS

$ FreeAUD Number of attendees

Donate to our Equipment Fund

$10.00AUD Quantity

Total

$0.00AUD

Southern Edge Arts