Student’s name…………………………………………………………………………………………………

Students date of birth and current age……………………………………………………………..

Students or responsible adults

telephone number (mobile)……………………………………………………………………………….

E mail address for scripts,

information about shows etc……………………………………………………………………………..

Anything else you want us to know about you? Anything we can do to support you in your tuition? For example dyslexia, epilepsy, asthmatic, learning difficulties etc (please give as much info as possible) …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Responsible adult to call in an emergency.  Mobile and home telephone numbers, address and a 2nd and/or  emergency contact number

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

 

IF OVER THE AGE OF 18 AN ADDITIONAL FORM MUST BE COMPLETED.

Please view our Safeguarding and Child Protection Policy via www.meladrama.co.uk

 

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