Event Registration

By participating in this online workshop you assume all risks of injury as a result of engaging in any movement activity. Dance for Parkinson's Australia is not responsible for any injury sustained by you during the course of any movement activity.

If you have any questions or need help with the registration form please contact us at: 1800 954 382 or dance@dancepdau.org

43 Email (*)
49 Name (*)
59 Privacy (optional)

Tick the following if you wish your profile to be hidden from other participants. Please note: your profile will be visible to the event administrators but not to other participants.

60 Emergency Phone Number (*)
For your safety we require an emergency phone number. We recommend you list the phone number of someone who we can contact in an emergency (such as a family member, friend or carer who we could contact during the event). Please note: this phone number is visible to the event administrators only. Other registrants will not see this phone number.
47 Mobile (optional)
Sometimes event administrators send SMS messages to registrants (such as important information and reminders when sessions are starting). If you wish to receive event notifications to your mobile phone please list your mobile number. Please note: Your mobile number is visible to the event administrators only. Other registrants will not see your mobile number.
46 Location (inc. a postcode) (optional)
As a bare minimum, postcode and country (e.g. 3000 Australia).
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51 Surely You're Not a Robot! (*)