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10.01.2019 Years 5 & 6 Alderman White Consent Form

Please return to your primary school and forward to Karsten Stephan at Alderman White School, Chilwell Lane, Bramcote, Nottingham NG9 3DU                                                                    

Email: karsten.stephan@whpfederation.org

 

 

Alderman White School Theatre Project for pupils in Years 5 & 6:  

                                        ‘Around the World in 80 Minutes’

 

I would like my son/daughter to audition for the above project on Wednesday 16th January

5.00 – 6.30 pm.  I also agree to him/her taking part in the rehearsals and performances of the play as outlined in the letter and agree to take responsibility for his/her safe journey to and from these rehearsals. I also accept that photos may be taken of the show and that a video-recording may be made of the performance.

 

Pupil’s name:                             ………………………………………………………………………

(Please print)    

 

Primary School:                         ……………………………………………………………………...

 

Date of Birth:                           ...…………………………………………………………………...

 

Parent’s/Carer's name:             ….………………………………………………………………….

(Please print)

 

Parent’s/Carer’s contact no:   ..……………………………………………………………………..

                                                      

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Address:                                 .     .…………………………………………………………………….

                                                

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Health or diet-related issues of which staff at Alderman White should be aware:

 

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Parent’s/Carer’s Signature:      …………………………………………………………………….