Nenagh Youth Theatre Membership Form – Nenagh Arts Centre

Nenagh Youth Theatre Membership Form

    Section A: Member Details

    Section B: Parent(s) / Guardian(s) Details

    Tick to consent

    Medical Conditions / Additional Requirements
    If you answer 'yes' to any of the below, please give details on the form or contact artsadmin@nenagharts.com in confidence.
    Please not that any information may have to be shared with others in the interest of your child's welfare. Any information provided with be treated as confidential and managed in line with the youth theatre's Confidentiality Policy.

    1. Does your son/daughter/ward have any additional requirements? e.g. physical disability, learning difficulties or literacy issues.

    2. Does your son/daughter/ward have any medical conditions of which we should be aware?

    3. Have you been advised by your doctor that your son/daughter/ward is in an 'at risk' group in relation
    to COVID-19?

    4. Does your son/daughter/ward have any allergies?

    5. Is there any other information we need to be aware of that may impact on your son's/daughter's/ward's participation in youth theatre?

    Section C: Parental Consent
    Tick to Consent

    I give consent for:

    1. My son's/daughter's personal data, as provided, to be processed in line with the purposes detailed in the Privacy Statement at the end of this form.

    2. My son/daughter to attend weekly drama workshops.

    3. Photographs/Video Footage including my son/daughter can be used publicly in posters/flyers and/or newspapers for publicity purposes.

    4. Photos/Video Footage to be stored and used for archival purposes (All photos/video footage will be managed in line with the youth theatre's Use of Images Policy).

    5. First aid/medical assistance to be sought in the case of an emergency.

    6. I have informed the youth theatre of relevant information with regard to any medical conditions or additional requirements that relate to my son/daughter/ward through this form or through discussions with a youth theatre leader.

    7. I have read the COVID-19 Procedures for Tipperary Youth Theatre.

    8. I have completed the COVID-19 Declaration Form for my son/daughter/ward, and can confirm that they have no symptoms of COVID-19, are not self-isolating and are not awaiting results of a COVID-19 test. I understand that if there is any chance in this status, they cannot attend youth theatre, their GP must be contacted, and they must self-isolate for the required period.

    9. I have read the information provided by the youth theatre.

    10. I give consent to the above member to participate in online workshops.

    11. I understand that with the current pandemic, workshops may be moved online

    DISCLAIMER: By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.

  • The right to be informed about how we will use your personal data

  • The right of access to a copy of the personal data we hold and information on how we process it.

  • The right to had incorrect or incomplete personal data corrected.

  • The 'right to be forgotten' and have personal data deleted if you so request.

  • The right to restrict how we process your personal data.

  • The right to object to the processing of your personal data.

  • The right to data portability.

  • To be completed by the Parent/Guardian
    I consent to the use of personal data provided for the purposes outlined in the above privacy Statement.

    DISCLAIMER: By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.

    Contact Us

    Nenagh Arts Centre,
    Banba Square,
    Nenagh,
    Co. Tipperary
    E45 NX26
    Phone: 067 34400
    Email: artsadmin@nenagharts.com

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