Theatre that never leaves you...

Parental Registration Form

Youth in the Ville – Summer Drama Experience Powered by Mooville Theatre & Marlene McKenzie Theatre

A. Child’s Information

First name:

Last name:

Date of Birth:

Day

Month

Year

Address:

School:

School Year:

Dates Attending: (Please note: Payment covers the full 8-session training and experience.)

July 24 & 25 (Thu/Fri)

July 31 & Aug 1 (Thu/Fri)

August 7 & 8 (Thu/Fri)

August 13 & 14 (Wed/Thu)

B. Parent/Guardian Contact Details

Name of Parent/ Guardian:

Primary Phone number:

Alternative Phone Number:

Email:

Are you employed / self-employed?

Yes

No

If yes, please specify:

Are you in receipt of benefits?

Yes

No

If yes, please specify:

C. SEND Information

If your child has any special educational needs and/or disabilities (SEND), please provide details so we can ensure an inclusive and supportive experience:

D. Parental Consent

I hereby confirm that the above information is accurate and that I give permission for my child to participate in the Youth in the Ville Summer Drama Experience. I understand that this information will be used to ensure proper communication and to best accommodate my child’s needs.

Parent/Guardian Signature:

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Date

Day

Month

Year

Thank You 😊

Mooville Theatre CIC

07736337365

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