Online Form - Library & Art Gallery Registration Form - Generic All Ages

Full Name*

Contact Phone Number*

Email Address*

I am registering for the following event/program:*

I give permission to contact me about similar events/programs at Carnarvon Library & Art Gallery.*

YesNo

Do you have any dietary preferences we should be aware of? (eg Gluten Free, Lactose Free, Vegan, etc)*

Do you have any medical conditions we should be aware of? (e.g. allergies, epilepsy, diabetes, limited mobility etc.)*

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

YesNo