JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2023 Curtain Call Creative Registration Form
Contact form and medical form for Student Enrollment.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Student's Full Name
*
Your answer
Students Home Address (with Postcode)
*
Your answer
Date of Birth
*
Your answer
School Currently Attending (from Sept 2020)
*
Your answer
PARENT / CARER DETAILS
(These will be used as first emergency contact)
Name
*
Your answer
Address
*
Your answer
Contact Number
*
Your answer
Contact Email
*
Your answer
Relationship to Student
*
Your answer
SECOND EMERGENCY CONTACT
Name
*
Your answer
Relationship to Student
*
Your answer
Contact Number
*
Your answer
PERMISSIONS
Are you happy for your child to be photographed and/or video recorded? Will be used for promotional purposes.
*
Yes
No
Other:
If your child is of an appropriate age, do you give them permission to leave the premises on their own without an adult?
Yes
No
Clear selection
MEDICAL FORM
To be completed by Student's Parent or Guardian
Does your child have asthma?
*
Yes
No
If Yes, Please provide any details include treatment or medication.
Your answer
Does your child have any allergies?
*
Yes
No
If Yes, Please provide any details include treatment or medication.
Your answer
Does your child have any skin conditions?
*
Yes
No
If Yes, Please provide any details include treatment or medication.
Your answer
Does your child have a hearing or visual impairment?
*
Yes
No
If Yes, Please provide any details include treatment or medication.
Your answer
Does your child have any learning disability?
*
Yes
No
If Yes, Please provide any details include treatment or medication.
Your answer
Does your child have a physical disability?
*
Yes
No
If Yes, Please provide any details include treatment or medication.
Your answer
Does your child have any medical conditions?
*
Yes
No
If Yes, Please provide any details include treatment or medication.
Your answer
Does your child have any dietary requirements?
*
Yes
No
If Yes, Please provide any details.
Your answer
SIGNATURES
I agree that we, as both parent/guardian & student, will adhere to any and all guidelines and/or rules set out by Curtain Call Creative, regarding COVID-19?
*
I agree
Required
I hereby confirm that all the information provided above in both the contact form and medical form are accurate and correct. (To confirm, please print your full name below as a signature)
*
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Curtain Call Creative.
Report Abuse
Forms
