Get Involved: Registration Form

Sparks

January – March2017

Sparks January - March

Sparks

Sparks is an exciting lively and established youth theatre for 5 – 7 and 8 – 11 year olds. Working with a professional theatre maker, children will be able to bring their imaginations to life through theatre.

Day: Saturdays

Time:

10 – 11am ages (5 – 7)

11:15 – 12:15pm ages (8 – 11)

Price: £40 per child per term

Term Dates

Saturday 14thJanuary 2017 / Sparks 5-7 10am – 11am
Sparks 8-11 11:15 – 12:15
Saturday 21st January 2017 / Sparks 5-7 10am – 11am
Sparks 8-11 11:15 – 12:15
Saturday 28th January 2017 / Sparks 5-7 10am – 11am
Sparks 8-11 11:15 – 12:15
Saturday 4th February 2017 / Sparks 5-7 10am – 11am
Sparks 8-11 11:15 – 12:15
Saturday 11th February 2017 / Sparks 5-7 10am – 11am
Sparks 8-11 11:15 – 12:15
Saturday 18th February 2017 / Sparks 5-7 10am – 11am
Sparks 8-11 11:15 – 12:15
Saturday 4th March 2017 / Sparks 5-7 10am – 11am
Sparks 8-11 11:15 – 12:15
Saturday 11th March 2017 / Sparks 5-7 10am – 11am
Sparks 8-11 11:15 – 12:15
Saturday 18th March 2017 / Sparks 5-7 and Sparks 8-11 10am – 11am
Showcase 11:15am

Get Involved: Registration Form

Participant Name:
D.O.B
Group (s):
Name of Parent/Guardian:
Address:
Town:
Post Code:
Home Tel:
Email:
Name of School/College:

The Core strives to be an Equal Opportunities Employer. It aims to establish and maintain a working environment, terms and conditions of service and employment practices and procedures which will ensure that no job applicant, employee, placement, actor or member of one of our groups/workshops receives less favourable treatment on the grounds of race, religion, belief, colour, nationality, ethnic or national origins, disability, gender, marital status, sexual orientation or age. We are required by our principal funders to monitor ethnic origin, gender, sexual orientation and disability, and would be grateful if you would complete this form to enable us to do this. The information provided will be treated as strictly confidential. It will be used for monitoring purposes within the organisation and will assist us to make decisions that will ensure that we remain an Equal Opportunities Employer. Please note the categories used are those recommended by the Office of National Statistics and the charity Stonewall.

I would describe my (the young person) ethnic origin as (please tick appropriate box)

English/Welsh/Scottish/Northern Irish/British / Irish / Gypsy or Irish Traveller / Any other white background / White and Black Caribbean / White and black African / White & Asian / Any other mixed/multiple ethnic Background
Indian / Pakistani / Bangladeshi / Chinese / Any other Asian Background / African / Caribbean / Any other Black/African /Caribbean Background
Arab / Any other ethnic group / Not Known/prefer not to say

Gender

Male / Female / Transgender / Prefer not to say

Disability

Do you have a physical, sensory or mental impairment that seriously affects your day-to-day activities? (Please tick as appropriate)

Yes No Information Declined to be given 

(This definition includes people with heart disease, diabetes, epilepsy, severe disfigurement, depression, schizophrenia, Down's syndrome, dyslexia and many other types of impairment).

Please describe any special requirements you need while at The Core as a result of your disability:

………………………………………………………………………………………………..

EMERGENCY INFORMATION

These details are needed in case support is needed immediately - please give as much information as possible. For under 18’s this will usually be a parent or guardian.

Emergency Contact 1 / Emergency Contact 2
Name: / Name:
Relationship to Participant: / Relationship to Participant:
Contact Number (s) : / / Contact Number (s) :

Permissions & Consent (18 and Over can sign for themselves for Photo/video consent)

I give permission for photographs, audio and video footage of my child to be used for educational, promotional or publicity purposes by The Core and by project partners.

I give permission for my child to leave the theatre building alone at the end of the session

Please note that if you are not allowing your child to leave alone, a member of staff will stay with them until you pick them up. If applicable please state below the collection arrangements for your child

I have read and understood the enclosed terms and conditions document and I am familiar with the warning system that The Core operates for anyone not meeting our behaviour expectations.

I, the parent / guardian of …………………………………………………………………. agree to all the permissions that have been ticked above.

Print name......

Signed......

Relationship to Participant ......

Date...... /...... /......

PLEASE COMPLETE THE REGISTRATION FORM AND HANDOVER TO BOX OFFICE OR JODIE LEES ON

PLEASE NOTE THAT WITHOUT REGISTRATION FORM AND PAYMENT BY THE FIRST SESSION ACCESS TO WORKSHOPS WILL NOT BE PERMITTED

Payment can be made at Box Office