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1. Full Name:

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2. Email Address:

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3. Age:

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4. Gender:

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5. Contact Number:

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6. Emergency Contact:

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7. Are you:

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8. Please indicate your availability below (tick all that apply)

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9. Please indicate which days you are available to participate (tick all that apply):

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10. How often do you want to participate?

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11. Would you like to be a part of The Moving Feast student leadership team, who assist with administration tasks?

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12. Please indicate what areas most interest you (tick all that apply)

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13. How did you hear about us?

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14. I hereby agree to complete the USC health and safety training module at
http://www.usc.edu.au/connect/work-at-usc/health-safety-and-wellbeing/training-and-induction
before attending my first gardening workshop

(You must complete this training in order to participate)

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15. By completing this registration form, you hereby agree to your details being stored for future contact regarding research and that photographs taken may be used or altered for promotional, educational or teaching purposes.

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16. Would you like to receive our monthly newsletter to stay up to date with The Moving Feast?

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