Railway House Adult Enrolment Form

Please complete the form below to enrol in classes at NCRNH

Classes Enrolling In (Tick all that apply)

Art ClassCommunity LunchCommunity Singing GroupCooking ClassEnglish ConversationFolks on Spoke Cycling GroupGardeningInclusive YogaIntroduction to Sustainable GardeningKnitting & Crochet CircleMen’s Strength TrainingRailway Readers Book ClubSewing for BeginnersTable TennisTai ChiWomen’s ExerciseOther
If Other, please specify

Participant Details

First Name (required)
Last Name (required)
Address (required)
Email (required)
Contact Number (required)
Main Language Spoken at Home
Healthcare Card Holder
Are you an Aboriginal or Torres Strait Islander?

How Did You Hear About The Class?

Photo Consent

Do you give permission for your photo to be used in promotional materials for Railway House?

Emergency Information & Consent

Please list any relevant MEDICAL CONDITIONS or ALLERGIES
Emergency Contact Name (required)
Emergency Contact Number (required)

Privacy

All personal information is kept confidential and in accordance with information privacy laws. Please contact us if you would like further details on our privacy policy.

Payment

Please contact the office to make your payment. The following methods of payment are accepted:

Card (preferred) either in the office or over the phone
Cash in the office
Bank Transfer

Bank details:
Account Name: North Carlton Railway Neighbourhood House
BSB: 313 140
Account: 1205 4263

We acknowledge there may be financial barriers for some members of our community in accessing programs for which there is fee. Please talk to staff if this is the case for you. We are committed to ensuring participation by all.