Simply Drama Student Registration Form
Student Name
*
First Name
Last Name
Student date of birth
*
Parent/Guardian Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Phone Number
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Parent/Guardian Email:
*
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Number
*
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My Products
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Simply Little Drama Home Ed, suitable for ages 4-7 THURSDAYS 9.45am-10.45am (September 3rd - October 22nd)
£64.00
£
64.00
Simply Little Drama Home Ed PAY AS YOU GO
£9.00
£
9.00
Simply Little Artists Home Ed, suitable for ages 4-7 THURSDAYS 11.00am-12.00pm (September 3rd - October 22nd))
£64.00
£
64.00
Simply Little Artists Home Ed PAY AS YOU GO
£9.00
£
9.00
Drama/LAMDA - Acting (optional) Home Ed, suitable for ages 8-13 WEDNESDAYS 11.00am-2:00pm (September 9th - October 21st)
£140.00
£
140.00
Drama/LAMDA - Acting (optional) Home Ed, suitable for ages 8-13 PAY AS YOU GO
£22.00
£
22.00
Musical Theatre Club, suitable for ages 8-16 WEDNESDAYS 5.30pm-6:30pm (September 9th - October 21st)
£52.50
£
52.50
Musical Theatre Club PAY AS YOU GO
£8.00
£
8.00
GCSE Drama Home Ed, suitable for ages 12-16 FRIDAYS 9:30am-11:30am (September 4th - October 23rd)
£200.00
£
200.00
Simply Junior Drama Home Ed, suitable for ages 8-11 FRIDAYS 12.45pm-1.45pm (September 4th - October 23rd)
£64.00
£
64.00
Quantity
1
2
3
4
5
6
7
8
9
10
Simply Junior Drama Home Ed PAY AS YOU GO
£9.00
£
9.00
Quantity
1
2
3
4
5
6
7
8
9
10
Simply Junior Artists Home Ed, suitable for ages 8-11 FRIDAYS 2.00pm-3.00pm (September 4th - October 23rd)
£64.00
£
64.00
Quantity
1
2
3
4
5
6
7
8
9
10
Simply Junior Artists Home Ed PAY AS YOU GO
£9.00
£
9.00
Quantity
1
2
3
4
5
6
7
8
9
10
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Health Information (for under 18s)
*
Rows
Yes
No
If yes, please explain.
Does your child have any restrictions regarding physical activity?
Will your child need any special assistance during the sessions?
Does your child have any allergies?
Does your child require/carry an EpiPen?
Is there there anything else you feel I should know regarding your child's health?
Please note that I cannot give your child over-the-counter or prescription medication whilst in my care.
*
Rows
Yes
No
I acknowledge and accept.
Photography and Filming Consent
Rows
Yes
No
I give permission for video of my child/my child’s photograph to be used on Simply Drama’s website.
I give permission for videos of my child/my child’s photograph to be used on Simply Drama’s social media pages.
I understand that these videos/photos will be stored securely and used only for the purposes stated above.
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