Stage 65 Youth Theatre: Live Sessions

Registration details - Summer Term 2021

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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

Wednesdays, Group 3 (academic year 6 & 7), 4.30pm - 5.30pm
Salisbury Arts Centre

Wednesdays, Group 4 (academic year 8 & 9), 6.15pm - 7.15pm
Salisbury Arts Centre

Wednesdays, Young Company (academic year 12+), 8pm - 9pm
Salisbury Arts Centre

Thursdays, Group 2 (academic year 4 & 5), 4.30pm - 5.30pm
Salisbury Arts Centre

Thursdays, Group 5 (academic year 10 & 11), 6.15pm - 7.15pm
Salisbury Arts Centre

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* 4. Address

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* 5. Postcode

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* 6. School Attended

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* 7. Parent/Guardian's Full Name

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* 8. Relationship to Young Person

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* 9. Email address (Payment details will be sent to this email address)

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* 10. Home Tel Number

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* 11. Mobile Tel Number

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* 12. 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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* 13. Relationship to Young Person

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* 14. Tel Number

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

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

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

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* 18. Is the young person a young carer?

Yes

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

You give us permission to administer First Aid

You give us permission to produce recordings including photographs during Stage 65 activity for Wiltshire Creative marketing including online and social media

You give permission for limited physical contact with fellow participants and project leaders which can be involved in Stage 65 activity

You give us permission to contact you regarding various activities and opportunities for the Young Person including specialist workshops, auditions and ticket discounts

You give permission for the Young Person (16 and over only) to leave unaccompanied at the end of the session

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

Yes

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* 21. Payment

I will paying a full term fee of £67

I will be applying for a reduced fee of £47 (for families on low income - £11,000 for a single parent family / £15,000 for a family with two resident parents/carers)

I will be applying for a bursary and a reduced fee of £27 (for families in receipt of means tested benefits)

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* 22. Exemptions for face coverings young people in academic years 7 and upwards:

I am registering a young person in academic years 6 and below

I am registering a young person who is not exempt from wearing a face covering

I am registering a young person who has a physical or mental illness or impairment, or a disability which means they cannot put on, wear or remove a face covering

I am registering a young person who, when putting on, wearing or removing a face covering causes them severe distress

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* 23. You acknowledge that it is the parent/guardian's responsibility to inform Wiltshire Creative should the young person experience symptoms of and/or test positive for COVID-19 at the earliest opportunity

Yes