Company details First name This is an example of the instructions. For some reason the text is really small and we can't change that. Surname Job title Address line 1 Address line 2 Town County Postcode Email address Phone number Next Page Child protection or safeguarding policy It's best practice that organisations that involve children in performances, paid modelling or paid sport have a child protection policy, regularly review and update it, and ensure that all staff and volunteers are familiar with it. Does your organisation have a child protection or safeguarding policy? YesNo Previous PageNext Page Child protection or safeguarding policy When was your child protection or safeguarding policy last updated? Upload a copy of your child protection or safeguarding policy Previous PageNext Page Details of the activity What's the name and nature of the performances or activities? For example theatre, music, dancing, filming, sport, modelling. Describe what the child will be doing. Tell us about the environment they'll be performing in and any information that may help us assess the potential risks to the child List the places where the activities, performances and rehearsals will take place, including any time on location. Dates and times of activities, performances or rehearsals. If you don't know exact dates, tell us the number of days and the time period. What’s the approximate duration of the child’s appearance in the performance or activity? What's the expected total running time / duration of the activities or performances (including any rehearsals)? Have you completed a risk assessment? YesNo Previous PageNext Page Risk assessment Your risk assessment should set out how you'll manage COVID-19 risks for the child performer in all places of performance and rehearsal (in line with latest government and Health and Safety Executive guidance). Upload a copy of your risk assessment Do you have any more risk assessments to upload? NoYes Previous PageNext Page Additional risk assessment documents Upload risk assessment 2 Upload risk assessment 3 Upload risk assessment 4 Upload risk assessment 5 Previous PageNext Page Night work Leave blank if there's no night work involved. Approximate number of days For these purposes, any performance taking place after midnight and before the earliest permitted hour counts as an extension to the previous day. e.g. if the child performs on Tuesday and then performs after midnight in the early hours of Wednesday, that counts as one day (Tuesday). Approximate duration each day Reason the performance must take place at night We may want assurance that there is a good reason why the child is asked to take part in a performance or activity at night. Previous PageNext Page Payment and contract How much will the child earn by taking part in the performance / activity? Name and address of the person who will be paid (if not the child) What is their relationship to the child? Upload a copy of the contract showing the agreement for the child to be involved in the performance or activity Previous PageNext Page School Details of the child's current school or private tutor (if they don't attend school) School name and address Will the child need any time away from school? YesNo Previous PageNext Page How many days or half days will the child need off school? Upload a copy of the school's authorisation for the absence Education arrangements during the child's time away What arrangements are there to educate the child during their time away from school? Name of the school / person teaching the child Address of where the child will be taught What courses / subjects will the child be studying? How many children will be taught at the same time? (Give ages and gender of each child) Previous PageNext Page Chaperone / parent / teacher who will have care of the child Name Chaperone's email address Name of the local authority / education authority who approved the chaperone How many children will they be looking after? (Give ages and gender of each child) Previous PageNext Page Accommodation and travel Address of where the child will live (if different from child's home) Number of children and details of the chaperone who will live in the same location (if different from child's home) Arrangements for transport to and from the performance, activity or rehearsal Approximate time the child will spend travelling to and from the place of the performance, activity or rehearsal each day Names of any other local authorities / education authorities you've applied to for another child to take part in similar performances or activities Previous PageNext Page Information about the child Child's name Address line 1 Address line 2 Town County Postcode Date of birth Upload a copy of the childs birth certificate Upload a photograph of the child taken within the last 6 months Previous PageNext Page Previous licences Details of licences granted for this child over the past 12 months Name of the authority Date the licence was granted Dates and nature of performances or activities Have any licences been denied for the child over the past 12 months? YesNo If yes, who denied the licence? What was the reason the licence wasn't granted? Let us know of any performances or activities the child has done over the past 12 months where a licence wasn't needed. (Include date and title of the performance, number of days, and name and address of the person in charge of the production) Tell us any dates the child has been away from school over the past 12 months because they have taken part in a performance or activity Previous PageNext Page Medical declaration Does the child have any of the following? (tick all that apply) NoneAsthmaAllergiesSkin conditionsHearing loss / deafSight loss / blindLearning disabilityPhysical disabilityNeed for regular medication Other conditions? (please state) Have they seen / been referred to a hospital consultant in the last 6 months? Previous PageNext Page Parent / carer's details Parent's name Address line 1 Address line 2 Town County Postcode Email address Phone number Previous PageNext Page I certify that the details in this application are correct to the best of my knowledge Date Previous Page Submit