Thirsk Youth Dance - Consent  Form
Please fill out this consent form if you are new to Thirsk Youth Dance and would like to participate in the online or face to face studio classes.
By filling out this consent form you understand that if you engage in the live dance sessions you agree that you do so at your own risk, you are voluntary participating in these activities, assume all risk of injury to yourself or your child. You agree to release and discharge Thirsk Youth Dance Company & Katy Hewison from any and all claims or causes of action, known or unknown, arising out of Thirsk Youth Dance Company/Katy Hewison negligence. As with all dance and exercise programs, when using our video clips and live dance sessions you need to use common sense. All children should be fully supervised by an adult when learning and participating. We strongly recommend that you risk assess the environment that you will be performing these exercises in and make sure they are clear of hazards.

Thankyou!
Any questions please don't hesitate to get in contact.
Katy Hewison
Thirsk Youth Dance Group Leader.

Get in touch via: thirskyouthdance@gmail.com 
All of our dance tutors are professionally qualified. 
Thirsk Youth Dance is apart of Rural Steps, a youth dance project funded by Arts Council England, Craven District Council, York and North Yorkshire Dance Hub, York St John University, Yorkshire Dance, and Create Arts Development Scarborough.
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Email *
Name of Participant: *
Date of birth *
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Address: *
Parent/Guardian Name: *
Relationship to Participant *
Emergency Contact Phone Number 1: *
Must be contactable during the time of the activity
Emergency Contact Phone Number 2: *
Must be contactable during the time of the activity
Participant Medical Details:
Please make us aware of any medical conditions or medication.
I (Parent/Guardian named above) give consent for my son/daughter (named above) to take part in Thirsk Youth Dance workshops (online/in person): *
Required
Media Consent
We would like to use photographs and film of you, as well as information you provide about yourself in case studies, to populate printed and digital marketing material, success stories, testimonials and for use on social media. You can consent to Thirsk Youth Dance (part of Rural Steps) using photographs and film of you and/or content from case studies by ticking the relevant boxes below. In the case of young people aged under 18, we require consent from a parent or guardian on their behalf and adhere to protect the young person through our Child Protection Policy.

If you provide your consent below, you are agreeing that Thirsk Youth Dance (and Rural Steps affiliated parties) can use your images in photographic and film format and/or content from case studies about you in any type of marketing materials including (but not limited to) websites, websites of other affiliated organisations, on and offline publications, public relations messages and other advertising, such as social media, brochures, information leaflets, adverts, posters and other formats to promote Thirsk Youth Dance and its activities. You agree that the photographs, film and/or case studies may be used in this way without payment or further contact from Thirsk Youth Dance, for the foreseeable future. Please note that your photographs/film/case studies may be used together or may appear individually.

Photographs, film footage and case studies will only be used by Thirsk Youth Dance and Rural Steps affiliated parties within the specific project they were taken and will not be passed to third parties for marketing purposes.

If you would like further information, a copy of this form or to tell Thirsk Youth Dance that you no longer want your images and/or case studies used in the ways outlined above, please contact Katy on thirskyouthdance@gmail.com

I (Parent/Guardian named above) give consent for my son/daughter (named above) to be photographed/filmed as part of Thirsk Youth Dance. *
Required
I (Parent/Guardian named above) give consent for my son/daughter (named above) to feature in future Thirsk Youth Dance Case Studies.
Only the participants first name will be featured.
How did you hear about Thirsk Youth Dance
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Your answers to the questions above take place of a signature. If you have any questions in the meantime, please don’t hesitate to contact Katy: thirskyouthdance@gmail.com. Thankyou, we look forward to seeing for the workshops!
A copy of your responses will be emailed to the address you provided.
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