Please complete this enrolment form for Children’s Mixed Media Australiana Workshop (Ages 9-12) with Olivia York

    Parent/Guardian firstname (required)

    Parent/Guardian last name (required)

    Parent/Guardian email address (required)

    Parent/Guardian phone number (required)

    Student first name (required)

    Student last name (required)

    Student age (required)

    Third party emergency contact name (required)

    Third party emergency contact relationship to student (required)

    Third party emergency contact phone number (required)

    Do you give Melbourne Art Class permission to include images of your child's artwork in our online gallery and digital marketing materials? (required)

    Please tick the box to confirm that you have read, understand and agree to our withdrawal and refund policy (required)

    Does your child have any special requirements to access the studio, or during the class (eg. wheelchair access, sensory impairment etc.)?