North Road East
Co Durham
TS28 5AX
Telephone: 01429 838783
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Performing Arts Summer School 2017
Summer School poster website 2.jpg
Child's Name: *
Date of Birth: *
Child's Gender: *
Full Address: *
Telephone Number: *
Email Address:
Which school do you attend and what year are you in as of June 2017?
Are you entitled to Free School Meals?    No
Will you require transport during the Summer School?    No

Data Protection

PLEASE NOTE:Wellfield Community School will place the information on this sheet ontoa database for use by members of the Production Team only.  This will assist us in organising the smoothrunning of the Summer School.  We willnot pass on your details to any third party without your express permission.  By signing this form you agree to us usingyour information in this way.

Where did you hear about our Summer School? (e.g. friends, school, internet, etc.)
Please use this space to list any previous theatrical experience your child may have:

Medical Section

WellfieldCommunity School wants to ensure that we can look after you all to the best ofour abilities when you are working with us. To make certain that we can maintain a safe environment at all times wewould be grateful if you would inform us of any medical conditions that weshould know about (e.g. asthma, diabetes, food allergies, etc.)  Also please inform us if your child carriesany medication with them (e.g. inhaler, etc.). All information shall, of course, be kept strictly confidential.

Pleasecomplete as applicable.

We have no medical conditions to inform you of. (please tick if applicable)
We have the following medical conditions to inform you of:

Dietary Requirements

Does your child have any specialdietary requirements (e.g. vegetarian, etc.)?

Pleasecomplete as applicable.

We have no dietary requirements to inform you of. (please tick if applicable)
We have the following dietary requirements to inform you of:

Photo / VideoPermission Section

When your child is working withWellfield Community School there may be occasions when members of the ProductionTeam either photograph or video rehearsals. These form part of our evaluation process, and provide us with materialto promote the work of the school.

By signing below you are indicatingthat you agree to Wellfield Community School using any photographs or videofootage (in any form and/or medium) which reasonably promotes or advertises theaims of the school.  The copyright ofsuch material will be assigned, and will remain the property of WellfieldCommunity School.  This consent will begoverned by the laws of England and Wales.


Bysigning below you are indicating that you have understood all the informationyou have been given and that you agree to all the points made.  You are also showing that you understand thatall participants MUST be available for ALL rehearsals and shows, and thatyou appreciate that it is not possible to only do a few days as participantswill be paired up (for example) for dance routines etc. and so must attend allsessions in order that their partner(s) does not miss out.

Parent / Guardian Full Name: *
Date: *

Once you have clicked submit your details will still be shown but don't worry your application has still been sent.

If you wish to submit another application for a second child, you will need to close your browser and re-open this page.
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