Students full name *

Date of birth *

Parent/Guardian name *

Parent/Guardian email *

Address with postcode *

Mobile *

Home Phone

Emergency Phone *

Important: Disability/ Allergy/ Learning Needs. Please give details

Do you give permission for us to share medical/disability information with authorised staff if needed (e.g. your student's teacher). MTA only share medical/disability information when it necessary to ensure safety and/or participation in sessions. *
YesNo

Student's Gender *
MaleFemaleprefer not to say

Borough the student lives in
LewishamGreenwichBromleySouthwarkOther

School/College the student attends:

Please tick here if you allow your child/children to go home without supervision *
YesNo

If you are new to Montage how did you hear about us? *
Internet SearchWord of MouthMagazine/Press AdvertFlyerYour SchoolOther

Please tell us where you got the information about Montage?

I accept that upon submitting this form that I agree to the Conditions of Membership. I authorise MTA to add the information on this form to the Members database. *
Yes

Read our Conditions of Membership

I am happy to receive infrequent information via email regarding further Montage courses, shows and events. *
YesNo

This data will be stored with GDPR compliant company MailChimp

I have read, understood and agree to Montage Theatre Art’s Privacy Notices. *
YesNo

MTA have my permission to take photos/video during classes, workshops, events and performances for the purposes of marketing, publicity and/or archiving. *
YesNo

These will never be shared with any identifying information (age, location etc.). There may be times where we will share first names, but only with the explicit consent of the parents.

Some attendees at events may film/take photos for their own personal use (e.g. parents of other participants). Do you consent to this? *
YesNo

Please understand in the interests of Data Protection, by selecting no, we will not be able to allow any parent/guardian to record a show in which your child appears.