Registration Form

15-17
18-24
25-34
35-44

45-54
55-64
65+

Will you have children
with you at the workshop?

Yes

No

If yes, how many?

What are their names and ages?
(Children under 15 should be accompanied by an adult. All participants over 15 must submit individual registration forms)

Are you or your children of Aboriginal or Torres Strait Islander descent?

Yes

No

Is it ok for a worker from the FVPLS Victoria to contact you in a few months to talk about the workshop you have attended?

Yes

No

Do you give the FVPLS permission to take photos of you (and your children, if any) on the day and possibly use and disseminate those images in FVPLS publications, web pages and other material without payment to you?

Yes

No

This is voluntary, but helps the FVPLS to promote and inform others of its activities. By agreeing on behalf of your children you represent that you are their parent or legal guardian with authority to give this consent on their behalf. If you have consent to the FVPLS taking photos of you (and your children, if applicable), you can contact us any time if you want to request us to stop producing new material with those images. Please understand that we may not always meet requests to stop using materials where they are out of our reasonable control or have already been produced or finalised. You may contact the FVPLS to request access to images of you and your other personal information.

Have you attended an
SDO workshop previously?

If yes, at which location?

Yes

No

Please indicate your t-shirt size:

Please submit your registration three work days
prior to the date of the workshop.