Young Ambassadors registration form

Registration details

Question Title

* 1. Young Person's Full Name

Question Title

* 2. Date of birth

Date / Time

Question Title

* 3. Address

Question Title

* 4. Town

Question Title

* 5. Postcode

Question Title

* 6. School Attended

Question Title

* 7. Parent/Guardian's Full Name

Question Title

* 8. Relationship to Young Person

Question Title

* 9. Home Tel Number

Question Title

* 10. Mobile Tel Number

Question Title

* 11. Email address

Question Title

* 12. Alternative Emergency Contact Name (this person will be contacted if we cannot get hold of the above in an emergency)

Question Title

* 13. Relationship to Young Person

Question Title

* 14. Tel Number

Question Title

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

Question Title

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

Question Title

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

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

Question Title

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

Yes

Thank you for completing the Young Ambassadors registration form.

The Take Part team will be in contact with you shortly.