SB PRODUCTIONS WORK EXPERIENCE STUDENT ENROLLMENT FORM

STUDENT ENROLLMENT FORM
STUDENT DETAILS
FULL NAME
Preferred Gender
Date Of Birth

MonthDayYear
Date
Email Address
example@example.com
Phone Number

Area CodePhone Number
Address
School Name
School Address
Grade/Year Level
Supervising Teacher
Supervising Teacher Email
example@example.com
PARENT/GUARDIAN DETAILS & EMERGENCY CONTACT/MEDICAL INFORMATION
Parent/Guardian Full Name
Relationship To Student
Email Address
example@example.com
Telephone Number

Area CodePhone Number
Address If Different From Student
EMERGENCY CONTACT INFORMATION: (If same as Parent/Guardian please check box)

As Above
EMERGENCY CONTACT FULL NAME
EMERGENCY CONTACT TELEPHONE
EMERGENCY CONTACT EMAIL
example@example.com
Please provide any relevant medical information OR conditions we should be aware of
PROGRAM OPTIONS

Choose your preferred category for gaining practical experience (select as many as you like and list any other areas not listed which you would like to explore):
ActingSingingDancingModellingMusic Recording & PerformanceSocial Media & MarketingMake-Up, Hair and ProstheticsRadio and TV BroadcastingEvent Staging & ProductionCommunity Engagement In ArtsFilm Set OperationsFashion & CostumingOther
I,hereby give my consent for my child to participate in the SB Productions Arts and Entertainment Work Experience Program, co-ordinated by SharonBrooks. I understand the nature of the program and confirm that my child is under 18 years of age.
PRINT PARENT NAME
Parent/Guardian Signature

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Date

MonthDayYear
Date
I herby confirm my interest in participating in the SB Productions Arts and Entertainment Work Experience Program, co-ordinated by Sharon Brooks. I understand the responsibilities and opportunities that come with this program and agree to abide by the rules and guidelines set by the organizers.
Student Signature

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Date

MonthDayYear
Date
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STUDENT ENROLLMENT FORM

STUDENT DETAILS

PARENT/GUARDIAN DETAILS & EMERGENCY CONTACT/MEDICAL INFORMATION

PROGRAM OPTIONS