U17 Norwich Theatre Take Part Registration Form Registration Details Question Title * 1. Which Workshop/Course/Class are you booked on? OK Question Title * 2. Participants Full Name First Name Surname OK Question Title * 3. Participant's Date of Birth DD/MM/YYYY Date OK Question Title * 4. Participant Address Details Name Address Address 2 City/Town Postcode OK Question Title * 5. Parent/Guardian Full Name First Name Surname Relation to Participant OK Question Title * 6. Parent/Guardian Contact Details Email Address Telephone No OK Question Title * 7. Parent/Guardian Address Details (ignore if the same as participant) Address Address 2 City/Town Postcode OK Question Title * 8. Alternative Emergency Contact Details (this person will be contacted if we cannot get hold of the above in an emergency) First Name Surname Email Address Telephone No (the contact number must be different from the number given above) Relation to participant OK Question Title * 9. Are there any access, medical problems (allergies, any regular medication taken) we need to be aware of? Family or other information can be discussed with the team directly or entered in the box below as well. OK Question Title * 10. Consent & Agreement (Ticked boxes will assume consent) You give us permission to administer First Aid in a medical emergency You give us permission to produce recordings including taking photographs during a Norwich Theatre Course/Class/Workshop for marketing purposes to be used across our website, social media, press and print You give permission for the participant to leave unaccompanied at the end of the session You give permission for the named participant to take part in relevant course/class/workshop activities and have read the terms & conditions outlined on the the course page on the website or via www.norwichtheatre.org/take-part/participant-information/ OK Question Title * 11. Marketing Communications Preferences - You give us permission to contact you regarding various activities and opportunities for the participant including specialist workshops, auditions and ticket discounts across the Norwich Theatre stages (Un-ticked boxes will assume no consent for marketing communications) Email Post OK Virtual Creative Activity Participation AgreementPlease ensure you have read the online procedures and participation documents we have emailed you. OK Question Title * 12. Under 18 years old Online Participation I agree to my child taking part in Norwich Theatre online virtual activities I agree to Norwich Theatre keeping a record of this form for safeguarding reasons I understand that the session will be recorded for safeguarding purposes I understand that my child needs to follow the code of conduct and any safety rules so that Norwich Theatre can keep them and other children safe OK DONE