January holiday writing workshops
Child’s name ……………………………………………………………………….………………………………
Grade ……………………………………………………………………………………..……………………….….
Preferred workshop date: ……………………………………………………………………………………..
Medical conditions ……………………………………………………………………………………….….…..
Food allergies ………………………………………………………………………………………………………
Parent’s name ………………………………………………………………………………………………………
Contact number ………………………………………………………………………………………..……..…..
Emergency contact name ………………………………………………………………..………………..……
Emergency contact number ……………………………………………………….…………………….…….
I give permission for a photograph of my child/ren to be used for promotion in future events by Karen Comer and Side Door ………………………………………………………………………..