Craic Summer Scheme Registration

Name of Child/Young Person

Address

Telephone Number

Date of Birth

Date

School Year Group in 2021/2022

Parent/Guardian Name

First Name Last Name

Relationship to Child/Young Person:

Contact No’s in emergency

Email Address:

example@example.com

Name(s) & Year Group of any siblings in Craic Youth Theatre

Consent to be included in photos/videos (Please choose)

Yes No

Medical needs and emergency procedures
IT IS ESSENTIAL THAT THESE ARE GIVEN FOR HEALTH & SAFTY PURPOSES

Has your son/daughter any medical conditions or allergies, If YES please give details.

Yes No

Comments

Has your son/daughter any special requirements?

Yes No

Comments

In the event of Craic being unable to contact the person names as the
primary contact, please nominate a second responsible adult we could
contact

Name

First Name Last Name

Tel Number

Relationship to Child/Young Person:

Can Craic produce photos or video footage of your child which will be used for promotional and archive purposes by The Craic Theatre

Yes No

I give consent for my son/daughter to take part in Craic activities to include workshops and performances

Yes No

I allow my daughter/son to leave the Craic Theatre premises alone

Yes No

WHEN YOU SUBMIT THIS FORM YOU ARE AUTOMATICALLY ACCEPTED FOR THE SUMMER ACADEMY AND YOUR CHILD/YOUNG PERSON CAN ATTEND THE CLASSES SUITABLE FOR THEIR AGE GROUP- NO NEED FOR CONFIRMATION.