Student Enrol

Student First Name*

Family name*

Date of Birth*

Gender

Male

Female

Other

Prefer Not to Say

Jedi

Relevant medical and health information

Phone No*

Your email*

Additional Contact Name*

Additional Phone*

Message

Is there any custodial information or any Family Court orders affecting custody of, or access to the children?*

No

Yes

Media Release I give full media release for images and video to be captured in class for learning purposes and shared on official social media accounts and website for promotional collateral/posts.*

Yes

No

Terms, Conditions and Cancellation. Perth Youth Film Academy (PYFA) and its employees, agents or contractors shall not be liable for any loss, damage, injury or harm suffered by you, your child or children, in connection with the Program howsoever caused. In the event of a medical emergency involving your child or children, you consent to Perth Youth Film Academy seeking all necessary medical assistance in response to that emergency. You agree to indemnify Perth Youth Film Academy against any costs Perth Youth Film Academy might incur in seeking such medical assistance. REFUNDS: PYFA will refund courses booked over 4 days from commencement. Covid19: We will always follow government procedures and restrictions regarding Covid19. Should classes be canceled due to restrictions, we will offer to refund or credit for any weeks closed. I confirm that I have disclosed all relevant medical and health information as per the above. I agree that I have made Perth Youth Film Academy aware of all physical, mental or health conditions which could be aggravated, worsened or impaired by my child’s participation in the Program. I consent to medical treatment being administered to my child in an emergency. *

Yes I Agree

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