September Physical Youth Theatre Registration Form

Prime are closely following the guidelines from Public Health England and the National Youth Association to ensure that we are Covid secure.

Places are limited to a maximum of 12 due to social distancing and will be offered on a first come, first served basis.
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Email *
Young Person's Details
Name
Date of birth
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/
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Address
How would they describe their gender?
How would they describe their ethnicity?
Which School/College do they attend?
What year group are they in?
If you would like us to contact your young person directly please provide an email address, this will be the main contact for weekly newsletters and workshop updates.
Young person's contact number (if applicable)
Parent or Guardian Details
Name
Relationship to the young person
Please confirm the best email address to contact you (the parent/carer) *
Contact telephone number 1
Contact telephone number 2
Would you like to be the first emergency contact for the young person?
Clear selection
Second Emergency Contact
Name
Relationship to the young person
Contact telephone number
Will they ever pick up/drop off the young person?
Clear selection
Permissions
Please state any medical or access needs
Please state any educational or social special circumstances we need to know about
Please state any custody or permission circumstances we need to know about
Health and Safety
In event of emergency, Prime will act in loco parentis and in an emergency will take reasonable actions (including calling an ambulance) to protect the welfare of your child.
What is your Doctor's surgery?
What is the contact number of your Doctor's surgery?
Are you happy for your child to leave workshops and return home unaccompanied?
Clear selection
If no, who will be the main contact for picking up/dropping off? Should your child not be collected within 15 minutes after their workshop we will use the emergency contacts.
We often take photographs or videos of performances and workshops. Do you give permission for your child to be recorded?
Clear selection
By signing up to be a member of Youth Theatre you give permission for us to use your contact details for Prime Theatre, these will not be passed on to a third party and will be deleted 2 years after your membership expires
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Payment
We understand financial circumstances may have changed during the Coronavirus pandemic. Prime Youth Theatre offers a limited amount of subsidised places. If you would like to apply for a grant place, please indicate below. We consider grants from everyone who meets one or more of the following: has a household income under £25K, is on the Government furlough scheme or has been made redundant as a result of Covid, is eligible for free school meals, is a Swindon Child Looked After/Care Leaver or identifies as Deaf. All information will be kept confidential. Please note grant places are limited. *
You will receive a confirmation email confirming your place in the Pilot programme and details of how to pay/apply for a grant within 2 working days. Thank you!
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