Women on Wheels Workshop at Chester Hill Public School

Number of Registrations 1

First name *

Last name *

Phone *

Email *

Do you require an interpreter? If so, which language? *

Which school hub do you attend? * Banksia Road Public School
Bass Hill Public School
Bankstown Public School
Chester Hill Public School
Chester Hill North Public School
Villawood East Public School
Fairfield West Public School
Prairievale Public School
Smithfield Public School

Lunch will be provided during the event. Do you have any dietary requirements? If so, please write them below. *

At this event, we will have child-minding available for children under 5 years of age. Do you have any children who you will bring to the event who will require child minding? * Select ... Yes No

If you answered yes, please provide the name and age of each child. Please note only children who have been added to this registration form can attend child-minding. *

How did you hear about this event? * My hub leader told me about it
I saw the flyer at my children’s school
My friend told me about it
Other

Photo Consent: I give permission for organisers to take photos of myself (and my child if they are attending with me). Any photos of me taken at this event can be used by Karitane, Community Hubs Australia, Transport NSW, Women on Wheels or my school for promotional materials and on social media. * Yes
No

How confident do you feel about keeping yourself and your children safe in the car? * Not confident
A little confident
OK
Confident
Very confident

How well do you understand road rules and laws about car maintenance and children’s car seats in Australia? * Not at all
A little
OK
Well
Very well

What is your age? * 18-20
21-30
31-40
41-50
50-plus

What is the make/model/year of your current car? *

What is your driving status? * Full licence holder
P-plate driver
Learner driver
No licence

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