Registration Form Register for CYT Easter Project 15th - 18th April 2019 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 your child to leave the project unaccompanied at the end of the sessions? Please confirm by ticking this box * Yes No Please tick which project you would like your child to join: * CYT Productions (aimed at children aged 5-12 years) Monday – Thursday 10am - 3pm Cost £100.00 per child CYT Peer Leader Scheme (for young people aged 13+) Monday - Thursday 9.30am – 3.30pm Cost £60.00 per child 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 Please tick to confirm you wish to register a place I confirm reCAPTCHA Submit
