Confidential Data Sheet

Welcome to The Man In The Moon.

(Workshop)

It is important that we have the correct contact details and information about all our members on file. Please complete this data sheet fully using a separate one for each child.

Childs Name Home Address

Date of Birth

Postcode Mothers/Carers Name

Home Telephone Number

Mothers/Carers Mobile Telephone Number Fathers/Carers Name Fathers/Carers Mobile Telephone Number In an emergency, if we were unable to contact you, an additional contact would be helpful. Alternative Contact Name Alternative Contact Telephone Number Relationship to Child We send home all our important information via email, significantly reducing the amount of paper we use, saving both time and the environment. We do not share your contact details with anyone else. We need an up to date email address for everyone that is checked regularly. You have the option to change your mind about information you receive from us via the link at the bottom of the emails we send you. You can even opt out entirely. However if you chose to do this, you will not receive any updates from us at all if you choose to do this. Your Email Address Care Information (Please give us details of any allergies, special needs etc.)

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Payment Fees are paid in advance at the beginning of term and are non-refundable. Late payment incurs a 10% administration charge. We reserve the right to charge a further 10% on accounts more than four weeks overdue. Hoodies A MIM hoodie should be worn to all workshops and rehearsals. Insurance We hold full cover for public liability. However, we are unable to accept responsibility for personal property that becomes lost or damaged. Face Paints Occasionally we use face paints at workshops. They are high quality, hypoallergenic, non-toxic and easy to remove. You can find a safety data sheet online: www.snazaroo.com.

include your child with your permission, given below, and will never mention childrens names. On occasion, parents may be allowed to take photographs and record performances for their own private and personal use. You understand that if you take photographs or record performances (when permitted), they are for your sole personal use and must not be used for any other purpose including uploading to the Internet.

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I give permission for my child to be included in photographs/recordings. I do not give permission for my child to be included in photographs/recordings.

Behaviour High spirits are welcomed, but if a child is continually disruptive, we reserve the right to suspend or exclude them. No refund will be given. Equal Opportunities Our workshops are open to any child regardless of gender, race or disability, subject only to availability of places. Workshop Cancellation Very occasionally, due to circumstances beyond our control, we may need to cancel a workshop. If a workshop has to be cancelled we will email parents and put a message on our website and social media. We will do everything that we can to reschedule the workshop. In the event of prolonged inclement weather this may not be possible. In this case, we regret that we are unable to refund the missed workshop. Leaving We must receive half a terms written notice if a child wishes to stop coming to workshop. If this is not received, half a terms fees are payable in lieu of notice.

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I give permission for my child to use face paints. I do not give permission for my child to use face paints.

Medical In the event of illness or accident you will be contacted immediately. If this is not possible, an ambulance will be called and your child will be sent to hospital. Photography/Recording On occasion, we take photos or videos of the children taking part in our workshops and productions. These images and recordings may be used for display purposes, printed publicity material, uploaded to our website, uploaded to social media sites (such as Facebook, Twitter and YouTube) and made available to other people. We will only

Parent/Carer Signature Date / /

The Man In The Moon, Passfield Business Centre, Lynchborough Road, Liphook GU30 7SB www.themaninthemoon.co.uk Telephone: 01428 751656

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