Name

Parent/Carer if under 18 (Full Name)

Parent/Carer Contact Details (ONLY if under 18)

Participant contact details (ONLY if over 18)

Photo Permission

Photo permission - We sometimes use pictures/films of students taken during classes/workshops/shows for promotional use, including social media platforms and on our website. Do you give permission for your young person/ yourself to be included in these photos/films?

Medical

Does the participant have any medical conditions/accessibility requirements that we need to be made aware of? If YES, please give details, including any medication taken

Dietary Requirements

Does the participant have any dietary requirements that we need to be made aware of? If YES, please give details.

Public Liability Insurance

“I understand that whilst at a Somerset Youth Theatre, my child will be covered by Public Liability Insurance. However, I absolve the Somerset Youth Theatre staff from liability resulting from any irresponsible action carried out by my child during their attendance.  In the event of sickness or an accident requiring emergency hospital for my child, I authorise an employee of Somerset Youth Theatre to sign, on my behalf, any written form of consent required by the hospital authorities, if the delay to obtain my signature is considered inadvisable by the doctor concerned. “ (Please initial & date.)