Application Form Drama School for a Day

Course Applying For*

Full Name*

Gender*

Male
Female

Date of Birth*

Age*

Name of Parents/Guardian (if applicable)

Correspondence address (please notify us if this changes)*

Postcode*

Home Phone Number*

Mobile Number*

Email*

Leaving Premises*

I do permit my child to leave premises during break times
I do not permit my child to leave premises during break times

Medical conditions/information. Please state what they are.*

Emergency Contact Name*

Emergency Contact Number*

First Aid*

By ticking this box, you are giving permission that in the case of an emergency, a qualiﬁed faculty member may administer First Aid to your child. Also for a teacher/assistant to administer the contents of the ﬁrst aid kit when there is medical need. If you are not happy to do so please discuss this with one of the principals of the school.

How did you hear about us?*

Payment

Upon application, you will be sent an email including bank details in order to transfer the fee.

WE CANNOT ACCEPT CHEQUES OR CASH AND PAYMENT MUST BE RECEIVED BEFORE THE EVENT

Publicity Release

I acknowledge and understand that without any compensation or notiﬁcation to, or approval by the undersigned or Participant, the participants name, photograph, video, audio and biographical information may be used, reproduced or otherwise be disseminated or published by or on behalf of the Dorset School of Acting/youth theatre for any purpose, including, but not limited to, advertising and/or promotion of the Dorset School of Acting/youth theatre.

Conditions of Enrolment*

I have read, understood and agree to the Dorset School of Acting Conditions of Enrolment

Signature*