Summer Registration Form

Welcome to Stage Academy

COVID SECURE SUMMER HOLIDAY WORKSHOPS AGES 4-18

Please fill in all the requested details as soon as possible so we can prepare to welcome your child

1 Parent/Carer Details

2 Child Details

3 Confirmation

Select Your Child's Venue, Course and Date*
Parent/Carer Name*
First Last
Email*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Enter your child's details here
Name Date of Birth
Edit

Delete
There are no Entries.
Maximum number of entries reached.
Emergency Contacts
Name Phone number
Edit

Delete
There are no Entries.
Maximum number of entries reached.
Please provide us with emergency contact details for your child. We need at least two emergency contacts and we ask that at least one of them isn't a parent.
Pick-up Adults
Name
Edit

Delete
There are no Entries.
Maximum number of entries reached.
We will only let your child go home with an authorised pickup adult, please list the names of all those who you would like to authorise to pickup your child from Stage Academy. You can always add or remove adults in the future. If your child if aged 10 or over you can choose to let them go home alone. Tick the box below to do so.
For children aged 10 and above only
- I authorise my child to leave Stage Academy on their own at the end of their class. I understand that Stage Academy can take no responsibility for my child once they leave their Stage Academy activity in this case.
Medical needs and allergies
Please give the full details of any medial needs are allergies your child may have. If your child requires any medication beyond and EpiPen or Inhaler we will be in touch to take further details from you so please make this clear in this box.
My child needs an...
- EpiPen
- Inhaler
If your child needs an EpiPen on Inhaler it must be shown to a member of the Stage Academy team on arrival each day. We will have to refuse entry to Stage Academy if you have told us your child requires this and it is not present.

Name	Date of Birth
		Edit Delete
There are no Entries.

Name	Phone number
		Edit Delete
There are no Entries.

Name
	Edit Delete
There are no Entries.

Welcome to Stage Academy

COVID SECURE SUMMER HOLIDAY WORKSHOPS AGES 4-18

Please fill in all the requested details as soon as possible so we can prepare to welcome your child

Basic details