Saturday Drama Workshops
Cherwell Theatre Company
Registered Charity Number 1137145

Saturdays During Term Time
CTC Saturday Drama Workshops:
5-8 yrs -- 9am-9.45am
8-10 yrs -- 10am-11am
Drama Studio, Banbury College (Main Campus), Broughton Road, Banbury, OX16 9QA

Contact us: info@cherwelltheatrecompany.co.uk

Please fill in the below information for young person/participant.
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Participant Information
CTC are committed to providing and promoting equality, diversity and inclusion for all young people and their families, as well as a safe and brave space for young people to be their unique selves. 
Participant's Full Name *
Participant's Nickname / Known As
Participant's Date of Birth *
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Email *
What is your relationship to the child? *
Participant's School
Participant's Gender *
Participant's Pronouns *
Participant's Address *
Participant's Ethnic Group *
Participant's Religion *
Primary & Secondary Emergency Contact
As a company we require all CTC members (under 16 and 16+) to provide a primary emergency contact which should be parent, guardian or carer plus a secondary emergency contact.
Parent/Carer/Guardian Details & Emergency Contact
Please note that the primary contact will be sent correspondence in relation to the workshop unless specified otherwise (to over 18s only)
Parent/Carer/Guardian's Full Name *
Relationship to Child *
Parent/Carer/Guardian's Email Address *
Parent/Carer/Guardian's Contact Number *
Parent/Carer/Guardian's Address (if different to participant)
Secondary Contact's Full Name *
Secondary Contact's Relationship to Child *
Secondary Contact's Email Address *
Secondary Contact's Contact Number *
Medical Needs/Condition
Please detail any medical needs and requirements of the Young Person/Participant. CTC may request more information and will contact you directly if this is the case.
Does the Participant have any pre existing conditions/allergies/injuries/wellbeing needs?
 *
If yes, please describe condition/needs and give details of young person's symptoms, triggers, signs, treatments, facilities, equipment or devices, environmental issues etc
Name of medication, dose, method of administration, when to be taken, side effects, contra-indications, administered by/self-administered with/without supervision
Describe what constitutes an emergency and the action to take if this occurs
Specific support for the pupil’s educational, social and emotional needs?
Please indicate if you are happy for a CTC practitioner to administer First Aid as required:
 *
Access Needs
Would the participant describe themselves as disabled?
 *
Would the participant describe themselves as neurodiverse?
 *
If yes, to any of the above, please describe any additional needs, support or disabilities we should be aware of:
Photo and Videography Consent
Please note, these may appear online and be distributed to local media.
I give consent for participant to be featured in photography or videography for CTC productions
 *
Online Consent
On occasion we may conduct sessions via zoom including but not limited to optional script read-throughs, youth steering groups and other online workshops. This may require registration from participants.

Please note, though our platform is secure, participant usernames will be visible to CTC staff and other participants on the forum. Though it is not necessary to use a participant’s full name, it is important we are made aware who registered participants are, as all users are accountable for their actions online.

We ask that all participants sign in with their full name.
I give consent for participant to take part in registered and non registered online workshops with CTC via the Zoom app
 *
I give consent for them to engage with other participants and staff in CTC’s secure forum
 *
Class Registration
Required Class
 *
Travelling Home
Participant safety is very important to us at CTC. Please tell us how your young person will travel home by ticking the box below
 *
Name of Person Collecting Child *
Payment
The full cost for the term is £60 and is paid at the start of
Autumn Term (September)
Spring Term (January)
Summer Term (April)

You may still be required to pay a term or half term fee if joining part way through.

Payment is via BACS, payable on receipt of a CTC invoice.  Cheque and cash payments are also welcomed

BACS:
Cherwell Theatre Company Limited
Sort Code: 60-01-35
Account Number 52197484

CTC is proud to provide bursaries to any young person to whom paying fees would present a barrier to attending our workshops. Should you have any concerns whatsoever about being able to pay termly fees, please email us at info@cherwelltheatrecompany.co.uk
Please indicate your payment method by ticking the box below:
 *
Required
Declaration
Signed by Parent/Carer/Guardian. Please type your full name.
 *
Date *
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Data Protection
We’d love to keep you updated about CTC’s work and ways you can get involved, as well as sharing news of activities you may be interested in. We will hold your details for our own administration and marketing purposes and promise to never sell or swap these with anyone else. We will hold your contact details during term time for emergency contact.  However, please do let us know your preferences for marketing contact from CTC.
Please tick as required. If you wish to change any of your details or contact preferences please email: info@cherwelltheatrecompany.co.uk
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