Songlines Sign Up Question Title * 1. Name of participant Question Title * 2. Age of participant Question Title * 3. Name of lead contact Question Title * 4. Will you/ guardian / family member be present at the workshops? (Optional as support worker will be present at every session) Yes No Question Title * 5. Contact Details Question Title * 6. Any allergies or medical conditions we should be aware of? Question Title * 7. Likes Music Art Animals Computers Science Languages Theatre TV Games Technology Food Other (please specify) Question Title * 8. Is the young person sensitive to any of the following Light Noise Touch Texture Colours Smell None of the above Question Title * 9. If you ticked any of the above please provide some further details. Question Title * 10. Please provide your contact details City/Town Email Address Phone Number Done
