Complete Your Registration Secure a spot in your chosen workshop today Student Details Parent/Caretaker Details Medical / Emergency Contact Details Media Consent Order Number Student Details Student First Name * Student Last Name * Student Date of Birth * Student Email Address * Current School Name * Current School Year Level * Mobile Number (If Available) How did you hear about MedPrep? Parent/Caretaker Details Parent/Caretaker First Name * Parent/Caretaker Last Name * Relationship to Student * Email * Mobile Number * Work Phone Home Phone Address * Suburb * State * State * SA VIC NSW ACT QLD NT WA TAS Postcode * Postal address if different to home address Suburb State State SA VIC NSW ACT QLD NT WA TAS Postcode Medical Conditions Are there any medical conditions for your child that should be made aware to MedPrep? If yes, please specify. Emergency Contact First Name * Last Name * Emergency Phone * Relationship * Media Consent Disclaimers I give consent for my child's photo to be published on MedPrep's printed materials. I give consent for my child's photo/video to be published on MedPrep's online promotional materials and channels. Check Out Our Range of Packages! PACKAGESCONTACT
