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Your child’s place will be secured once we have received your completed form below with your child’s essential information, and payment of £100 a day is received. A payment link will be sent to your email address.

Parent / Guardian's Name

First Name

Last Name

Phone

(###)

###

####

Which workshop are you interested in?

Dry Point Etching - 12th Aug

Lino Cutting - 13th & 14th Aug

Child's Name

First Name

Last Name

School Year of Child/Young Adult?

How did you hear about us?

Emergency Contact Name 1

First Name

Last Name

Contact 1 Phone

(###)

###

####

Contact 1 Email

List any medical concerns we should be aware of?

List an allergies

Do we have photoconsent to use photos of your child on the Art Place website?

Yes

Any other information we should know?

I have paid £100 a day for the workshop(s)

Yes

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