RYC Minis Registration Form
Please complete one form per participant to register for RYC Minis. If you wish to apply for a bursary, please also complete our bursary application form. This form must be completed by a person over the age of 18.
Participant Information
RYC minis is for those age 3-4 years old.
Name
*
First Name
Last Name
Preferred or other name
Date of Birth
*
-
Day
-
Month
Year
Date Picker Icon
Is the participant at a childcare setting or school?
*
Reception Year
Pre-School
Nursery
Childminder
At home
Other
Does the participant have any allergies, medical conditions or neurodiversity?
*
Yes
No
If yes, please tell us more
Emergency Contact Information
Emergency Contact 1
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
Town/City
County
Postcode
Are you the fee payer?
*
Yes
No
Emergency Contact 2 (optional)
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
Town/City
Country
Postcode
Terms and Conditions
You change consent at any time by contacting georgia.shire@rosestheatre.org
I consent to:
*
The participant taking part in this programme
The Roses keeping record of this form for health and safety, and safeguarding purposes
Any medical treatment that the participant may need to be given in an emergency
The participant being filmed or photographed during the programme, with such photographs or recordings being used for marketing and publicity with third party organisations
Signature
*
Submit
Should be Empty: