Animal Skills Workshop
What session date are you interested in attending?
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Please Select
6 October
Child's first name
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Child's surname
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Address
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email address (please note Government emails may not receive responses.) (Your automatic email may go to your spam folder so please check)
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How old are you?
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Does your Guardian approve?
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Please Select
Yes
No
Guardians full name and contact number
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Do you suffer from any health issues that may cause a problem during this program?
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Please Select
Yes
No
If you answered yes to health issues please list your health concerns so that we can ensure that you are cared for during this program
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Do you have any allergies, including special food requirements and animal allergies *
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Please Select
Yes
No
If yes to allergies what are you allergic to?
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If allergic to food what food are you allergic to?
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Tell us why you would like to be a part of our animal skills workshop*
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I understand if the child is under 10 years old a parent or guardian will need to stay during the workshop.
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Please Select
Yes
No
I understand that during this workshop we will be working with living creatures who deserve my respect as well as instructors and other people who are available to help me and the dogs in our care. I will respect them all and do my best to follow instructions and to care properly for the animals. *
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Please Select
Yes
No
I understand that the dogs may be frightened by loud or obnoxious behaviour and i will do my best to behave well while I am around the dogs so that they will enjoy the program as well *
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Please Select
Yes
No
I understand that PAWS Darwin and their team will take every care to support me through out this workshop and that should an accident occur that I will not hold them liable (blame them ) and that i will provide helpful information if i need support. *
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Please Select
Yes
No
I understand there will be a fee to attend this workshop and my booking will only be confirmed on payment of the fee.*
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Yes
No
Photos may be taken during the course of our program, these photos may be used for marketing and for grant acquittals, i am aware of this and give my permission for any photos to be used. *
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No
Emergency contact name and phone number *
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I declare that all information is correct at the time of signing this form.
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No
Date
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Guardian signature
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Clear