Registration details

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* 1. Young Person's Full Name (as it should appear in a programme)

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* 2. Date of birth of young person

Date

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* 3. Please select which group you'd like to join

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* 4. Would the young person be interested in completing an Arts Award as part of their involvement in online sessions?

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* 5. Address

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* 6. Postcode

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* 7. School Attended

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* 8. Parent/Guardian's Full Name

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* 9. Relationship to Young Person

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* 10. Email address (Payment details and session links will be sent to this email address)

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* 11. Home Tel Number

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* 12. Mobile Tel Number

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* 13. Alternative Emergency Contact Name (this person will be contacted if we cannot get hold of the above in an emergency and will need to be able to collect the young person if necessary)

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* 14. Relationship to Young Person

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* 15. Tel Number

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* 16. Are there any access needs we may need to be aware of? (e.g. mobility)

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* 17. Are there any medical conditions we may need to be aware of? (e.g. allergies, any regular medication taken)

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* 18. Is there anything we can do to support the young person's participation?

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* 19. Is the young person a young carer?

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* 20. Please tick the boxes if you DO consent to the following:

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* 21. You acknowledge that it is the parent/guardian's responsibility to update Wiltshire Creative with any change in contact details

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* 22. Payment

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