Stage Alchemy Theatre Club

Parent Registration & Booking Form

Autumn Term 2026

Venue: The Glebe Centre, Murton

Term Dates: Thursday 17 September – Thursday 10 December 2026

Half Term: Thursday 29 October (No Session)

Child's Information Child's Full Name

Birthday

Day

Month

Year

Age

8-11

12-18

Preferred Name (if different)

Parent / Guardian Details Parent/Guardian Name

Relationship to Child

Address

Phone

Email

Emergency Contact Emergency Contact Name

Relationship

Telephone Number

Medical & Additional Support Does your child have any medical conditions?

Yes

No

If yes, please provide details.

Allergies

Medications

Does your child have any disabilities or additional support needs we should be aware of?

Is there anything we can do to help your child feel comfortable and fully participate?

£25 deposit

£

Age 8-11

£

Age 12-18

£

Sibling Discount - Is this child eligible for our sibling discount?

No – this is the first child being booked

Yes – another child from this household is also attending

more than one other sibling is attending

Disability Does your child consider themselves to have a disability or long-term health condition?

Yes

No

Prefer not to say

Household Information (Optional) This information helps us understand whether we are reaching families from a range of backgrounds. Is your child eligible for Free School Meals?

Yes

No

Dont know

Prefer not to say

Photography & Media Consent

I give permission for my child to appear in photographs and videos used by Stage Alchemy Theatre Club and Backstage Builders CIC for promotional and funding purposes.

I do not give permission.

I confirm that the information provided is accurate and that I will inform Stage Alchemy Theatre Club of any changes to my child's medical or emergency contact details. I have read and agree to the Stage Alchemy Theatre Club Terms & Conditions and Privacy

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GDPR Privacy Notice

The information collected on this form will be used to administer Stage Alchemy Theatre Club, communicate with parents and carers, ensure the safety and wellbeing of participants, and anonymously monitor who we reach for funding and evaluation purposes.

Personal information will be stored securely, accessed only by authorised staff and volunteers, and processed in accordance with the UK General Data Protection Regulation (UK GDPR) and the Data Protection Act 2018.

You have the right to request access to your data, ask for corrections, or request deletion where appropriate. Equality monitoring information will only be used in anonymous reports and will never identify individual participants.

Parent & Carer Volunteering (Optional) Stage Alchemy Theatre Club is part of Backstage Builders CIC, a not-for-profit community organisation. We rely on the support of volunteers to help us provide creative opportunities for young people. If you have time

yes

no