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Balanced Living Festival Facilitators/Entertainers Application

Please enter information on the form below to process subscription for Balanced Living Festival Facilitators/Entertainers.

First Name *

Last Name *

Organisation

Address

Address2

Suburb *

Postcode *

Phone *

Email *

website

social media link

Presentation, Workshop or Performance

How long is your performance/presentation

Special requirements:

Would you like to donate your fee to support Kincumber Neighbourhood Centre With much needed funds to assist in the ongoing provision of services and programs in your local community.

YES

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Public Liability Details

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Expiry Date

Attach a copy of your public liability insurance

I accept Terms and Condtions

Security Code*

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Balanced Living Festival Facilitators/Entertainers Application

Public Liability Details

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