Young Ambassadors registration form Registration details Question Title * 1. Young Person's Full Name OK Question Title * 2. Date of birth Date / Time OK Question Title * 3. Address OK Question Title * 4. Town OK Question Title * 5. Postcode OK Question Title * 6. School Attended OK Question Title * 7. Parent/Guardian's Full Name OK Question Title * 8. Relationship to Young Person OK Question Title * 9. Home Tel Number OK Question Title * 10. Mobile Tel Number OK Question Title * 11. Email address OK Question Title * 12. Alternative Emergency Contact Name (this person will be contacted if we cannot get hold of the above in an emergency) OK Question Title * 13. Relationship to Young Person OK Question Title * 14. Tel Number OK Question Title * 15. Are there any access needs we may need to be aware of? (e.g. mobility) OK Question Title * 16. Is there anything we can do to support the young person's participation? OK Question Title * 17. Are there any medical conditions we may need to be aware of? (e.g. allergies, any regular medication taken) OK Question Title * 18. Please tick the boxes if you DO NOT consent to the following: You give us permission to administer First Aid You give us permission to produce recordings including photographs during activity for Wiltshire Creative marketing including online and social media 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 OK Question Title * 19. You acknowledge that it is the parent/guardian's responsibility to update Wiltshire Creative with any change in contact details Yes OK Thank you for completing the Young Ambassadors registration form. The Take Part team will be in contact with you shortly. OK NEXT