Register your Interest in CR

Register your Interest in Creative Relationships

Parent/Guardian/Carer Name

Child/Children Name

Child's Date of Birth

YYYY

Phone Number

Subject

Will there be children that need to attend with you?

Additional needs

Is there anything we need to be aware of (allergies/ medical conditions, factors that may impact upon participation, strategies that may assist inclusion)?

Consent for digital images

Digital images (still or video) may be recorded and stored strictly for the purpose of promotion and publication for Creative Relationships. Promotion and publication may include publication under the business name of Creative Relationships on social media sites Facebook and Instagram, inclusion in paper advertising (ie a paper flyer) and on my Website www.artisticclaire.com and under no circumstances for personal use. Digital images will be strictly limited to images of children’s artwork and children engaged in artwork only. No payment will be entitled for the use of any images.

Consent

I do/ do not (please select below) give consent for digital images (still or video) of my child and/ or their artwork to be recorded and stored for the purpose of publication and promotion of art classes under the business name of Creative Relationships. I understand that such images may be made public under the business name Creative Relationships only (and not for personal use).

I do

I do not

Which location would you like to book in for?

Would you like to be added to our contact list for future programs?

Yes Please

Message

Register your Interest in Creative Relationships

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