CL&AG - Registration Form - Teens Book Week Karaoke

Child's Full Name*

Age*

Do you want to sing your own choice of song at Book Week Karaoke?

YesNo

What is the title of your song choice?

Parent or Guardian Name*

Parent or Guardian Contact Phone*

Parent or Guardian Contact Email

I give consent for photos to be taken and for these images to be used, modified, and distributed by the Shire of Carnarvon.*

YesNo

OPTIONAL QUESTION: Does your child have any dietary preferences we should be aware of? (eg Gluten Free, Lactose Free, Vegan, etc)

YesNo