One-on-One Online Class Registration Form

Jordan Hill Creative Writing & Reading Workshop > One-on-One Online Class Registration Form

Child's Name*
First Last
Date of Birth
MM slash DD slash YYYY
Child's Age
Child's School*
Country of Resident*
Parent's 1 Name*
First Last
Parent's 1 Phone Number*
Parent's 1 Email Address*
Parent's 2 Name
First Last
Parent's 2 Phone Number (optional)
Parent's 2 Email Address (optional)
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Choose Preferred Day (subject to availability)*
- Select All
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Time (subject to availability)*
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GDPR Accepted On*
- I agree with storage, handling and use of my data and media by this Jordan Hill Creative Writing & Reading Workshop. We are committed to protecting your privacy and ensuring your data is handled in compliance with the General Data Protection Regulation (GDPR).
Name
This field is for validation purposes and should be left unchanged.

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