Sept – Dec 2019 Please complete one form per child Join Form If you are human, leave this field blank. Name of child * Date of birth * Address * Contact email address * Contact phone number * Emergency contact details * names and phone numbers of any adults who can be contacted in the event of an emergency Any medical conditions that we need to be aware of, including any allergies Please list any medication that will be brought to CYT sessions including details of how the medication will be stored and administered Is there anything else that we need to know that would allow your child to fully access the sessions Do you give permission for photos/video of the participant to be taken? * Yes No These may be used for documenting the project, shared with other participants or used for future publicity of the project. PARTICIPANTS WOULD NEVER BE REFERRED TO BY NAME By completing this registration form you are committing to sign up for Court Youth Theatre, and agree to pay this full terms fees (based on 8 weeks of sessions) Please tick to confirm you wish to register a place * I Confirm Places will be allocated on a first come first served basis Please select which session you wish your child to join: * 4-8 years 9.30 – 10.45 £77.00 8-12 years 11.00 – 12.30 £92.00 12-16 years 12.45 – 2.15 £92.00 reCAPTCHA Submit
