Please to register your child for the Plough Youth Theatre. Enter all the information in this form as accurately as possible. Participants Full Name * Parent/Carer's Full Name * Address * Postcode * Date of birth * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Date of birth of the participant Phone Number * Alternative Phone Number * Please provide another home, work or mobile number where we can contact you in an emergency Email * We will use this email address to keep you up to date with Youth Theatre and Outreach Projects. Health Issues Are there any health issues or concerns we should know about? This can include physical and mental health. Additional Needs Does your child have any additional needs that we should be aware of? This could include disabilities, learning difficulties, sensory issues, emotional triggers, social issues or anything else you feel is relevant. You can also include anything that we can do to help. Education * please let us know which school your child attends, or if you home educate. This can help with funding and other outreach work. Workshop(s) Participant is Attending * Theatre Tots (2-4 yrs) PYT Infants (5-7 yrs) PYT Juniors (8 to 11 yrs) PYT Seniors (11-14 yrs) PYT Senior Theatre Company (14-18 yrs) PYT Creative Movers (4-8 yrs) PYT Creative Dance (8-16 yrs) PYT Creative Scriptwriting (8-18 yrs) Has Participant Previously Attended PYT? * Yes No Where did you hear about PYT? Payment Are you a Plough Supporter? Yes No Payment * Online At the Box Office / On the Phone I Have Already Paid This is a free/funded session or free trial please let us know how you would like to pay, or if you have already paid, thank you Please submit this consent form and (if you haven't already done so) click the green "Pay Online" button on the listing page on or before the start of term or the next meeting. Please submit this consent form and (if you haven't already done so) pay at box office on or before the start of term or the next meeting. Photo/Video Consent * I consent to photos being taken of my child during PYT sessions I consent to videos being taken of my child during PYT sessions I consent to those photos being used on social media I consent to those videos being used on social media I consent to those photos being used in printed and web promo material I consent to those videos being used in web promo material I do not consent to any photos or videos Consent to Leave the Premises * I give consent for my child aged 11 years or older to leave the Plough Arts Centre by themselves during or at the end of a PYT session I do not give consent for my child aged 11 years or old to leave the Plough Arts Centre at any time This is not applicable to my child First Aid * I consent to first aid being administered to my child in any situation I consent to first aid being administered to my child only in an emergency TERMS AND CONDITIONS OF THE PLOUGH YOUTH THEATRE 1. PYT runs for 3 terms a year and will culminate in either a production or a sharing performance (other than Theatre Tots). The length of each term may vary but the fee will be the same for each of the 3 terms in that year. 2. PYT members are expected to pay for sessions by the first day of the term (or the week after a free trial). Once paid it is understood that the participant has committed to participate in the youth theatre and to attend as many workshops and rehearsals as possible, and to be available for the performance. If they subsequently decide not to attend or they miss workshops erratically then unfortunately, no refund can be given. 3. If workshops are at capacity, you can be added to a waiting list for that group or any additional workshops that are set up. 4. In addition to the timetabled sessions, where appropriate we will run extra rehearsal workshops by arrangement, at no extra cost to you. 5. At the start of each new term parents/guardians need to check their consent form is up to date. If it is not, they must fill out a new form. Additionally, PYT staff may need to update the form, in which case it will need filling out again. 6. Children cannot be left with PYT staff unless we have a consent form, which includes at least 2 emergency contact numbers. 7. Children aged 11 years old are able to leave the buildilng on their own ONLY If we have consent from a parent/carer. If we do not have this consent we will expect a parent or carer to drop off and collect children to and from the room in which the session is taking place. 8. During workshops, PYT members may be required to leave The Plough Arts Centre with adult supervision for purposes of filming, observational work or PR. We will notify you of this beforehand. Signing this consent form, means you give consent for this to happen, unless otherwise stated or communicated with PYT staff. 9. For all PYT sessions, unless children have consent to come and go on their own (see above), parents are now required to drop off and collect their children in the room in which the session takes place, ie, the auditorium/dance studio/meeting room, rather than in the box office area. 10. It is the parent/carer's responsibility to ensure the PYT member of staff knows if anyone different will be collecting your child. I agree that I have read and agree to the terms and conditions given, and that I consent for my child in my care to participate in PYT workshops. Signed Please use your finger (on a mobile or touch screen) or mouse to draw your signature below to indicate your consent. Signer Name *
