Registration form

Which group/s would you like to register for:

Drama 4 Change 10 years-16 years Drama 4 Change 16-25 years Mixed Group (The Show must go on) Little Slippers Neuro Divergent (Centre Stage)

Name

First Name Last Name

E-mail

Phone Number:

Area Code Phone Number

Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Birth Date:

Month Day Year

Parent(s)/Guardian(s) Details for anyone under the age of 18

Name

First Name Last Name

Email

example@example.com

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

If you are under 18 years of age ask a parent to fill in any medical details.

Section 1: Medical Conditions/ Additional Requirements: If you answer yes to any of the questions below please tick the box and provide extra information in the box below. Please note that this information may be shared with others in the interest of your child's welfare. Any information provided will be treated as confidential in line with The Cracked Slipper Company confidentiality policy.

Do You/ Your Child your child have any additional requirements eg Physical Disability, learning difficulties or literacy issues Do you/ your child have any medical conditions of which we should be aware of. Do you/ your Your child have any allergies Is there any information we need to be aware of or that may have an impact on your child's participation with the Cracked Slipper Company workshops

If you have answered yes to any of the above in section 1, please provide further information.

Section 2: Consent:

For myself/My Childs details in this form as provided to be processed in line with the purpose detailed in the privacy statement at the end of this form. Myself/my Child to attend workshops. For photo/film footage of myself/my child during Drama 4 Change activities and to be used for any publicity in relation to The Cracked Slipper Company workshops First Aid/ medical assistance yo be sought in the case of an emergency.

Where did you hear about us?

A Friend or colleauge Google Blog Post News Article workshops Other

I give consent for myself/ my child's participation in The Cracked Slipper Company workshops

Clear

Privacy Statement:

The personal data requested in this form is collected solely for the purpose of supporting your son’s/ daughter’s participation in The Cracked Slipper Company Community Youth Theatre Group "Drama 4 Change". Data such as contact details will be used to communicate with you and your son/ daughter in relation to your son’s /daughter’s membership of the Community Youth Theatre Group. Data such as gender and age is used to ensure your son / daughter is assigned to aspects of the Community Youth Theatre Group activities that are age appropriate. Sensitive personal data such as details of medical conditions or other personal needs are collected so that we can ensure the safety and welfare of your son / daughter whilst participating in The Community Youth Theatre Group. Information that is given COVID-19 will be used to support a young person’s safe participation in youth theatre activities during the pandemic. The accompanying COVID-19 Declaration Form will be deleted immediately once it has been assessed by the drama leader, has been recorded as being received and any necessary follow-up action has been taken. The Cracked Slipper Company is collecting this sensitive personal data for the purposes of maintaining the safety of all attending this group The legal basis for collecting this data is based on vital public health interests and maintaining occupational health. Your son’s/ daughter’s personal data will only be shared with those who need to know it, and only disclosed to a third party in the case of an emergency such as if they become ill or have an accident that requires medical attention. Images including video will be collected for the purpose of promoting and documenting the activities of The Cracked Slipper Company Community Youth Theatre Group, and for archival purposes. Images will be managed safely in line with our Use of Images Policy. The promotion of our productions and other events requires that on occasions images will be used in the public domain. The Cracked Slipper Company will retain personal data on file for a period of duration in which they are a member of The Community Youth Theatre Group when he/she leaves it will be destroyed. Personal data in the form of photographic images and video will be retained permanently or until such time they become obsolete for the purpose of promoting and documenting the activities of The Community Youth Theatre Group.

Your rights: The Cracked Slipper Company is committed to upholding yours and your son’s /daughter’s rights as provided for by the General Data Protection Regulation (GDPR) including: The right to be informed about how we will use your personal data. The right of access to a copy of the personal data we hold and information on how we process it. The right to have incorrect or incomplete personal data corrected. The ‘right to be forgotten’ and have personal data deleted if you so request. The right to restrict how we process your personal data. The right to object to the processing of your personal data.

Consent for the use of Personal Data:

The Cracked Slipper Company will use personal data only where consent to do so is affirmative, freely given, specific informed and unambiguous. The below privacy statement provides information on why we gather and how we use your personal data.

I have read, understood, and accepted the PRIVACY POLICY for Registration..

The Cracked Slipper Company Registration Form for All Classes