PLEASE NOTE: Due to licensing restrictions a performance fee cannot be paid to any child appearing in this production

Imagine Theatre Ltd Ref No.AS………..

Cinderella

Junior Chorus Auditions, The Adam Smith Theatre, Kirkcaldy

Child’s Full Name (Block Capitals please)

Address(Block Capitals please)

Post Code (very important!)

Contact details (contact details must be for parent/legal guardian NOT child)

Name (Block Capitals please)Relationship to Child

Is this the primary contact?Yes/ No If no, name of primary contact

Telephone Mobile

Email

Are you a member of the PVG scheme (for work with children) and would you be willing to chaperone the panto if needed? Yes/No

D.O.B. Age on 01.11.16 y mMale/Female

Please indicate what school year your child will be during performances

P5 P6 P7 S1 S2 S3 S4 S5 (children above year S5 at time of performance cannot audition):

School name

Education Authority

Name of dance school attended (if any)

Emergency contact detailsfor AUDITION DAY

Full Name (Block Capitals please)Relationship to child

Telephone Mobile

MEDICAL INFORMATION

Does the above named childhave any medical condition we need to be aware of, particularly on the audition day (e.g. Asthma). This information will remain confidential to the audition panel and is for welfare reasons only

Yes/No

If yes please give details:

PARENTAL/ GUARDIAN CONSENT

I hereby give permission for the child named above to participate in the auditions of this pantomime. I understand that the decisions made by Imagine Theatre Ltd are final. Should the above named child be successful in gaining a part in the pantomime he/ she will attend all rehearsals and performances he/ she is called for and adhere to all rules and instructions given. I also give permission for publicity photographs of my child to be taken on audition day, and if successful, for publicity / production photographs to be taken during rehearsal and at dress rehearsal which will be used for advertising and publicity purposes as well as our archive and I understand that photographs may be taken by the audience during the show and posted on social media and I am aware and give permission for this. I understand my child’s photograph will appear in the programme, and that a video of the production will be taken for advertising and archive purposes.

Signed ______Parent/ Legal Guardian/ Designated Responsible Adult

Block Capitals ______Date ______

If successful in getting a part inCinderellayou will be expected to make a full contribution to the success of the pantomime by using your talents in acting, singing and dancing, as directed, within the production. During rehearsals and performances you will be expected to comply with all production requirements, as laid down by the Theatre and Production Staff, regarding costumes and make-up and any other performance related matters. You will be required to attend all rehearsals and performances as called. Failure to do so may result in you being withdrawn from the production.

Imagine Theatre Ltd Data protection number: ZZ941659