Young Actors FORM

Young Actors Application Form
The workshops:

Weekly creative workshops focusing on drama, acting, directing, theatre making and performing in a safe and fun environment for young people age 11-17.

No drama experience necessary.

You must commit to at least 1 term of workshops. This is not a drop in project, as you will be working towards performances.

Mondays 6.00-7.30pm @ Grand Junction, St Mary Magdalene’s Church, Rowington Close, W2 5TF.

All our facilitators are DBS checked and have lots of experience delivering youth programmes.

If you have questions or would like any further information please email joanne@grandjunction.org.uk or text on 07515 197 492
Child/participant details
Name

First NameLast Name
Age and DOB
Ethnicity
I want to sign up a sibling: Name

First NameLast Name
Age and DOB
Child's school
Parent/carer details
Name

First NameLast Name
Parent/ Carer Phone Number
07989912345
E-mail
example@example.com
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact 1 (we will only contact this person if we cannot get hold of the main parent contact in an emergency)

Name

Number

Relationship to childState / Province

Postal / Zip Code
Emergency Contact 2 (we will only contact this person if we cannot get hold of the main parent contact in an emergency)

Name

Number

Relationship to childState / Province

Postal / Zip Code
Does your child require any additional support you feel would be helpful for us to know so we can support your child in the most appropriate way? If so, please give details.
Does your child have any medical or mobility issues? If so, please give details.
How did you hear about us?
Are you happy for your child to be photographed for future promotion on Grand Junction's website and social media?
Do you want you email added to our mailing list?
Tick if you give permission for your child to go home by themselves
If you want someone other than you to pick up your child, please enter the name of the adult collecting them, and relationship to child
Tick box to confirm that your child will attend all sessions
Parent/carer Signature
Should be Empty:

Young Actors Application Form

Child/participant details

Parent/carer details