UPCOMING SHOWS! | G4 Live in Concert - Sat 23rd Sept | Faith: The George Michael Legacy - Thur 28th Sept | Henning Wehn: Westphalia is not an option - Fri 29th Sept | Joe Longthorne - Saturday 7th Oct | An Evening with Nigel Farage - Sunday 8th Oct | The Vera Lynn Story - Friday 13th Oct | Rob Kingsley's A Vision of Elvis - Friday 20th Oct

APPLICATION FORM

YOUR DETAILS

First Name:

Surname:

Address / Postcode:

Email:

Phone Number:

Work Number:

CHILD DETAILS

First Name:

Surname:

Gender:

DOB:

Age:

School Year:

EMERGENCY CONTACTS

Primary Emergency Contact

Contacts First Name:

Contacts Surname:

Contacts Number:

Contacts Email:

Secondary Emergency Contact

Contacts First Name:

Contacts Surname:

Contacts Number:

Contacts Email:

MEDICAL INFORMATION

Hospital/Clinic name:

Doctor's name:

Contacts Number:

Contacts Email:

Known medical conditions:

Allergies:

Current Medications:

PHOTOGRAPHY PERMISSION

Please tick the correct box

give permission for performance photographs of my son/daughter to be displayed on the group (private) facebook page or in the press.