Next Steps Registration Form - Half Moon Theatre

Group(Required)

This is the group your young person will be joining. If you are unsure please contact us on 020 7709 8900 or nextsteps@halfmoon.org.uk

Child Preferred Name (if applicable)

Child Gender(Required)

Child Date of Birth (dd/mm/yyyy)(Required)

Child School Year(Required)

This is the year group they are currently in at school. Please enter NUMBERS ONLY into this box, the form will not recognise letters in your response and you will receive an error message.

Primary School(Required)

Secondary School (if known)

Main Parent/Carer Relationship to Child(Required)

Main Parent/Carer Mobile(Required)

Other Main Parent/Carer Relationship to Child

Other Main Parent/Carer Mobile

Emergency Contact Relationship to Child(Required)

Emergency Contact Mobile(Required)

Parent/Carer Signature(Required)

Please sign here to confirm your response

Child Ethnicity(Required)

This information is requested by the London Borough of Tower Hamlets for monitoring purposes. If you do not wish to provide this information, please select ‘Prefer not to say’.

Does your child receive any additional support, or have any access requirements that we should be aware of?

This could be a diagnosis your child has, or some strategies you use at home to encourage good behaviour, for example. Half Moon is an inclusive organisation that celebrates individuality and diversity, and we will work hard to support your child in the best way possible. If your child has a PEEP, please also inform us here

Does your child have any medical conditions or requirements that we should be aware of?

Is there anything else you'd like to tell us?

If you have any questions about anything in this form, or need more space to give us details, write it below and we will do our best to get back to you as soon as we can. Alternatively, you can email us at drama@halfmoon.org.uk.