Kinsale Arts Week 2006

Design an Arts Week Venue

REGISTRATION FORM
_______________________________________________________

Name
Address
Mobile Telephone No.
Home Telephone No.
Entry Category: Please tick Youth: Adult:
Date of Birth (youth)
Age (youth)
School Attended (youth)
Are you Entering as an Individual yes/no
If team entry, please list names:
PARENTAL CONSENT(youth) : Signed
Date

_______________________________________________________

Please return to:

Adrian Wistreich,
Ballinacurra,
Kinsale,
Co.Cork

_______________________________________________________

All entries must be registered by 30th April 2006. you can type in your details onscreen on this form - press the "Print" button below and ask your parent or guardian to sign the PARENTAL CONSENT at the bottom of the form.

SPONSERED BY