Poppet & Pearl Performance Academy
Childs Name
First Name
Last Name
Childs DOB
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Childs Age
Parent Name
First Name
Last Name
Email
example@example.com
Phone Number
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Area Code
Phone Number
Emergency Contact Name
First Name
Last Name
Emergency Contact Telephone Number
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Area Code
Phone Number
I can confirm my child would like to attend Poppet and Pearl Performance Academy on Wednesday evenings at The Dance Studio, Openwoodgate, Belper 4.30pm - 7.30pm and to attend dress/tech rehearsal at Create Theatre Mansfied on 14th June.
Confirm
I consent to my child being photographed or filmed in audition/rehearsal/production and for such materials to be used on the Poppet and Pearl website and social media
Yes
No
I understand that the cost of the performance will be £15 weekly for a 3 hour rehearsal to be paid in full at the start of each calender month.
Confirm
I understand there is a £30 joining fee (which includes a t shirt) to be paid if children wish to take part in the production.
Confirm
Signature
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