Circus Play – Workshops in Wonderment Please fill in the registration form Circus Play Workshop Registration Form Participant Details Name * Name First First Last Last Gender FemaleMaleNon-binaryPrefer Not To Say Age * Date of birth DD/MM/YYYY * Address * Street Address City/Town * Post Code * State * VictoriaNew South WalesTasmaniaSouth AustraliaQueenslamdWestern AustraliaAustralian Capital TerritoryNorthern Territory Email * Phone * Emergency Contact Phone * Do you have any siblings attending? * YesNo Please provide details for each sibling attending Sibling 1 - Name Sibling 1 - Age Sibling 1 - Gender FemaleMaleNon-binaryRather not say Sibling 1 - Gender Sibling 2 - Name Sibling 2 - Age Sibling 2 - Gender FemaleMaleNon-binaryRather not say Sibling 2 - Gender Sibling 3 - Name Sibling 3 - Age Sibling 3- Gender FemaleMaleNon-binaryRather not say Sibling 3- Gender If you are human, leave this field blank. Next
