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* 1. Please provide the participants name

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* 2. Please provide your residential address

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* 3. What school does the participant currently attend (if applicable)?

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* 4. What year level are they currently in?

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* 5. Who is completing this form, and what is your relationship to the participant?

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* 6. Please provide your email address

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* 7. Which workshop is the participant interested in attending?

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* 8. Does your young person have any additional needs that would help us prepare for your visit?

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* 9. How did you hear about this event?

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