Registration Form

Young Person's Details

* Select Workshop

* Full Name

* Date of Birth

* Gender

* Address

* Town

* Post Code

* Ethnicity Prime Theatre welcomes all members of the community and we like to check everyone feels included. Please tell us your ethnic background or family heritage.

Young Person's Email If they have one

Young Person's Phone Number If they have one

* Name of School / College

* Current Year Group

* How did you hear about Prime Theatre?

Parent or Guardian

* Name of Parent / Guardian

* Relationship to Young Person

* Parent / Guardian Email Main method of communication

* Parent / Guardian Phone 1

* Parent / Guardian Phone 2

* Will you be the main contact for picking up / dropping off the young person?

Yes No

* Would you like the contact above to be used in case of an emergency?

Yes No

Second Emergency Contact

* Name of 2nd Emergency Contact

* Relationship to Young Person

* 2nd Emergency Contact Phone 1

* 2nd Emergency Contact Phone 2

* Is this person going to be picking up / dropping off the young person?

Yes No

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Health and Safety

Please state any educational or social special circumstances we need to know about

Please state any custody or permission circumstances we need to know about

Please state any medical or access needs

IN THE EVENT OF EMERGENCY: Prime Theatre will act in loco parentis and in emergency circumstances will take reasonable actions (such as calling an ambulance) to ensure the welfare of your child.

* Doctor's Surgery

* Practice Phone Number

We are responsible for your child from 15 minutes before each workshop to the point they are released from their workshop or released back into your care based on your response to the following questions. Children aged 13 and under parents/guardians should collect their child from the Wyvern foyer once the workshop has finished. If your child is over the age of 14 please choose:

If you are happy for your child to leave workshops and return home unaccompanied please tick this box

If you are happy for your child to be met outside of the building then please tick this box

I will collect my child in person

Should your child not be collected within 15 minutes after their workshop we will use the emergency contacts

FILM/PHOTOGRAPH/AUDIO PERMISSION: We often take photographs/recordings of performances and/or workshops. If you DO NOT want your child to be recorded please tick this box

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