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Registration Details

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* 1. Young Person's Full Name

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* 2. Date of birth

Date

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* 3. Address

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* 4. Town

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* 5. Postcode

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* 6. School Attended

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* 7. School Year Group

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* 8. Parent/Guardian's Full Name

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* 9. Relationship to Young Person

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* 10. Home Tel Number

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* 11. Mobile Tel Number

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* 12. Email address

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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)

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* 14. Relationship to Young Person

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* 15. Tel Number

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* 16. Which group do you usually attend?

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* 17. Which Youth Theatre sessions would your young person like to attend (please ensure you select the correct option for their age)

  School Years 4, 5 & 6 - 3-3.45pm School Years 7 & 8 - 4-4.45pm School Years 9, 10 & 11 - 5-5.45pm School Years 12+ - 6-6.45pm
Wednesday 17 June 2020
Wednesday 1 July 2020
Wednesday 15th July 2020
Wednesday 29th July 2020
Wednesday 12th August 2020 

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

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

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

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* 21. Email address the Zoom link should be sent to

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* 22. Name of the Zoom account holder (name appearing on screen)

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

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

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* 25. You confirm that you have read the guidance available on the relevant page of the Wiltshire Creative website. Click here to read the document.

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* 26. What are you hoping to gain by taking part in this activity?

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* 27. Signed (a typed name will be acceptable in this instance)

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* 28. Date

Date
Payment - This activity is free at this time but you may make a donation through our website if you wish by clicking here.

Thank you for completing the Youth Arts registration form.
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