Register for your Child

Child's First name*

Child's Last name*

Parent Guardian name

Address

Council District

Email*

Phone

Child's Birthday

Day

Month

Year

What Stage is your child?

KS1

KS2

KS3

Does your child have a medical condition we need to know about? if yes please state

Do we have permission to take pictures and videos of your child, some of which to be used on social media?

Yes

No

Does your child receive pupil premium?

Yes

No

School your child attends

School Address

School Phone number

Head Teacher

Does the participant consider themselves to have a disability?

Yes

No

Is the participant in good health and capable of taking part in physical activity?

Yes

No

I consent to my child/young adult being dismissed without an adult from class, shows and any other event through Stageworks Academy (this includes walking to a car out of view)

Yes

No

I consent to Stageworks being able to physically assist & support my child in Acro, Dance & Aerial for safety and technical corrections.

Yes

Yes, subscribe me to your newsletter.

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