Application Form Youth Courses - Dorset School of Acting

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*

Payment

Upon joining, a link to sign up to GoCardless will be emailed to you along with a choice to pay termly or monthly. Upon reply, you will then be sent an invoice including a date by which fees will be collected - if you join mid-term fees will be calculated accordingly. An invoice will be sent prior to the commencement of each term.

PAYMENTS ARE MADE THROUGH GOCARDLESS.

We cannot accept cheques or cash.

Home Phone Number*

Mobile Number*

Email*

1x Compulsory Uniform T-Shirt Size*

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 first hear about us? i.e. Google search/Facebook/Word of mouth*

Payment

Upon joining, a link to sign up to GoCardless will be emailed to you along with a choice to pay termly or monthly. Upon reply, you will then be sent an invoice including a date by which fees will be collected - if you join mid-term fees will be calculated accordingly. An invoice will be sent prior to the commencement of each term.

PAYMENTS ARE MADE THROUGH GOCARDLESS.

We cannot accept cheques or cash.
No refunds will be issued.

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*