Please complete the below form by: 14/04/25

Show Permission Form - Once Upon a Circus

To be filled out by Parent / guardian (one form for each child)

Childs First name

Childs Last name

Date of Birth

Month

Day

Year

Contact First Name

Contact Last Name

Contact Phone Number

Any Medical information that you feel is appropriate

I confirm that my child is fit and well enough to take part in this years show and dress rehearsal

Child Dress / Costume Size / what do you usually buy (Please size up if in between sizes)

Child Height (in cm)

Child Chest (in cm)

Hips (in cm)

Inside leg (in cm)

Programme, Show filming and agreements

I agree to my child being photographed. I am aware that this may be used for promotional purposes

I agree to my child being filmed for the show DVD. I am aware that this may be used for promotional purposes

I give permission for my Childs name to appear in the show programme and end credits of the video

By ticking this box I confirm that it is a commitment to BOTH the show date (Sunday 22nd June) AND the dress rehearsal (Saturday 21st June)

I understand and accept that the show fee is non-refundable

Signature

Signature field is empty.