STAGES SUMMER SCHOOL 2024

This information is strictly confidential and will be kept on record in case of an emergency. In the case of the application being unsuccessful, this form will be deleted from files.

Young Person’s Full Name(Required)

Young Person’s Date of Birth(Required)

HAF Number

Any additional needs(Required)

Allergies(Required)

Dietry Requirements(Required)

Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Primary Contact - Full Name(Required)

Primary Contact - Relation To The Young Person(Required)

Primary Contact - Email Address(Required)

Primary Contact - Mobile Phone Number(Required)

Primary Contact - Home Phone Number

Primary Contact - Work Phone Number

Data Consent

I give permission for this data to be processed.

We will only contact you regarding these workshops.

Photo Consent

I understand that during the workshops, photographic and recorded images may be taken and used for publicity purposes, such as on the Grand Theatre’s social media pages, website, brochure and you tube channel. I give my consent for still images and recorded images of the young person to be used for publicity purposes.

I DO NOT give photo/recorded consent permission