SILENT MIND LONDON TOUR 2023

SILENT MIND TOUR

Booking Form
Confirmation of Details
School or college name*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Teacher name*
Email
example@example.com
Telephone contact number
Possible dates for the performances (check as many as needed - we will confirm your date in consultation with you later in the year)*

Tuesday 5 December AMTuesday 12 December AMTuesday 26 September PMTuesday 28 November PMTuesday 5 December PMTuesday 12 December PM
FOR PERFORMANCES ONLY Please breakdown timings for the day. We will require 1 hour to set up and can arrive anytime after 8.30 am. The performance is 1.15 hrs long and we will require 45 minutes to strike the set. We can perform after the school day; please note this here if that suits.
Parking space (for 2 cars)*

Yes, onsiteYes, nearbyNo
If yes, please describe
Required Information for the Silent Mind performance

Ideally the venue for the performance should have black out facilities.
Please describe your performance space (School hall, theatre)*
Does this space have a basic lighting rig?*

YesNo
If yes, please describe
Does this space have a sound system?*

YesNo
If yes, please describe
Please confirm whether you have a technician to demonstrate the above and to be on standby during the performance.*

YesNo
Additional elements
PLEASE NOTE:

The performance is appropriate for ages 12-25 and we can come to any secondary school or youth organisation. As this is a performance, we can perform to as many students as your venue allows. After the performance, there will be a 30 minute workshop. This works best in a smaller group with up to thirty students. Alternatively, this can be done by splitting the audience into six smaller groups, working simultaneously with different workshop leaders. The workshop does work more effectively in smaller and focused groups, if possible. There are no student indicators for this, but you may decide that certain students would benefit from a small group workshop on mental health. WARNING: We use flashing lights and music throughout the performance.
Please provide as much information as possible about the students: year group, approximate audience size, age range of students.*
Please state whether the performance and workshop is (select all applicable options):

Part of curriculum studyPart of an enrichment programmePart of RSHE deliveryOther
Please provide information on any SEN or disability student requirements. (Please note we will not be able to provide additional TAs or support workers; we ask that you put this in place to support all the students' needs throughout the performance and workshop as part of our Equal Opportunities monitoring.)
We will require some technical support with the sound system and lighting board prior to the performance of Silent Mind. Please can you provide a name and email address for a technician or colleague who can assist with this on the day. We will email them directly to discuss any requirements ahead of our arrival.
DATA PROTECTION CONSENT

THEATRE FOR LIFE would like to take photographs or video the group for promotional purposes. These images and video footage may be sent out to the media with a press release, to our funding providers or used for our publications or on our website and social media forums.

Note: if consent is not given, THEATRE FOR LIFE will not use any images taken during the activity that contains group members.
MEDIA CONSENT

YESNO
DECLARATION

I have provided information to the best of my knowledge to help the Theatre for Life enrich and support our student needs.

I will ensure that all SEN and disability needs are met by providing a qualified staff member to support the students needs during the performance.

I will ensure that staff members are present during the performance to maintain the correct ratio of students to adults.

I will ensure that any classroom management is suitably dealt with by a qualified staff members and will not expect the Theatre for Life team to discipline students.

I will ensure that any accidents are reported in the accident book and a form has been completed for both parties to sign.

I will ensure that the space and facilities are suitable for the performance and that I have liaised with Theatre for Life about any technical requirements.
Signature

Clear
Date
Should be Empty:

SILENT MIND TOUR

Confirmation of Details

Required Information for the Silent Mind performance

Additional elements

PLEASE NOTE: