"*" indicates required fields LinkedInThis field is for validation purposes and should be left unchanged.Name of Child* First Last Date of Birth*MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920GenderYour Pronouns* she/her he/him they/them Other – please let us know! Your Pronouns*Name of SchoolSchool YearAddress* Street Address Address Line 2 City Post Code Child's Email Parent/Guardian Email* Ethnicity (e.g. White British, Asian, British, Caribbean, Chinese)*This information is used for monitoring purposes only.Please let us know of any particular needs or access requirements they may have so we can best support your child. (These details may include, but are not limited to, Anxiety, Autism, Dyslexia.)Please note any medical information, conditions or allergies we should be aware of:Emergency Contact InformationContact 1: Name*Contact 1: Phone*Contact 1: Relationship*Contact 2: NameContact 2: PhoneContact 2: RelationshipPermissions and AgreementsName* First Last I am a:* Member Parent Guardian Behaviour Policy* I have read and agree to adhere to the behaviour policy.Photography Permission* I give permission for my child to be photographed or filmed. I do not give permission for my child to be photographed or filmed. We require permission from parents/guardians of our youth theatre members who are under 18. Participants without completed forms will not be photographed or filmed. Walk Home Alone* I give permission for my child to walk home alone after their session. I do not give permission for my child to walk home alone after their session. Privacy and Cookies* I have read and agree to the privacy policy.CAPTCHA
