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Poetic Relief
TP Academy (3-16 yrs)
TP Academy (3-16 yrs)
YP Academy (16+)
Young Peckham
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Member
Price:
£10
We need the following information about your child in order to provide the best possible learning experience and to make sure your child is safe when at Theatre Peckham. Please note that your child's place on their course is not confirmed until after this form is returned to us. ONE FORM PER CHILD/YOUNG PERSON:
We need the following information about your child in order to provide the best possible learning experience and to make sure your child is safe when at Theatre Peckham. Please note that your child's place on their course is not confirmed until after this form is returned to us. ONE FORM PER CHILD/YOUNG PERSON is not valid
Childs Full Name:*
Childs Full Name is Required
Childs Date of Birth:*
Childs Date of Birth is Required
Parent/Carer name:*
Parent/Carer name is Required
Parent/Carer phone number:*
Parent/Carer phone number is Required
Address:*
Address is Required
Postcode:*
Postcode is Required
Name of childs school or alternative:
Name of childs school or alternative is not valid
Emergency contact name (this must be different to the parent/carer named above):*
Emergency contact name (this must be different to the parent/carer named above) is Required
Emergency contact phone number (this must be different to the parent/carer phone number above):*
Emergency contact phone number (this must be different to the parent/carer phone number above) is Required
Can the child go home alone?:*
Can the child go home alone? is Required
Yes
No
Does your child have any physical, health or educational needs which we need to know about in order to support them?:*
Does your child have any physical, health or educational needs which we need to know about in order to support them? is Required
Yes
No
If you answered yes to the above please provide details about your child's needs here::
If you answered yes to the above please provide details about your child's needs here: is not valid
What is your child's ethnic group?:
What is your child's ethnic group? is not valid
Please choose the option below that best describes your child's ethnic group or background:
Asian/Asian British:
Asian/Asian British is not valid
Indian
Pakistani
Bangladeshi
Chinese
Any other Asian background
Black/Black British:
Black/Black British is not valid
African
Caribbean
Any other Black background
Dual Heritage:
Dual Heritage is not valid
White and Black Caribbean
White and Black African
White and Asian
Any other Mixed Background
Other:
Other is not valid
Arab
Any other ethnic group
Prefer not to say
White:
White is not valid
British
Irish
Gypsy or Irish Traveller
Any other White background
Name of TP Academy Class(es)/Company:*
Name of TP Academy Class(es)/Company is Required
Young Actors Company (17-25yrs)
Musical Theatre Acting and Dancing (3-5yrs)
Musical Theatre Acting and Dancing (6-9yrs)
Musical Theatre: Afro Dance Fusion (12-16)
Acro (5-15yrs)
Boys Ballet Soul
Young Music Producers (8-11yrs)
Young Music Producers (12-16yrs)
Ballet Academy Beginners
Tap Academy Beginners
Ballet Academy Intermediate
Tap Academy Intermediate/Advanced
Street Dance Academy (5-7yrs)
Street Dance Academy (8-11yrs)
Acting (8-11yrs)
Acting (5-7yrs)
Junior Acting Company (12-16yrs)
Musical Theatre Songs (5-7yrs)
Musical Theatre Songs (8-11yrs)
Musical Theatre (8-11yrs) ONLINE ACADEMY
Ballet Academy Beginners Tots (3-5yrs)
Tap Academy Beginners Tots (3-5yrs)
Y&T Theatre Creators (9-16yrs)
Backstage Academy (12-16yrs)
Ballet Advanced
Write to Perform (17-23yrs)
Ignite All Female Dance Company
Are you happy for TP to use photos of your child(ren) to appear in Theatre Peckham's marketing material?:*
Are you happy for TP to use photos of your child(ren) to appear in Theatre Peckham's marketing material? is Required
Yes
No
How did you hear about us?:*
How did you hear about us? is Required
Previous TP Member
Family member attends/ed TP
Search engine (Google, Yahoo etc)
Social Media
Printed material (poster, flyer etc)
Recommended by someone
Press
Other
I have read, understood and agree to the Terms and Conditions of the TP Academy detailed on the website*
Email:*
Invalid Email
Password:*
Invalid Password
Password Confirmation:*
Password Confirmation Doesn't Match
Have a coupon?
Coupon Code:
Invalid Coupon
No val
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