REGISTER FOR OUR RESIDENTIAL SUMMER CAMP

If you wish to purchase a place at our 2020 Summer Camp, please complete the form below to enrol your child. Once you have submitted the form, we will contact you to set up a payment plan.

Don't forget that we also offer easy payment terms where you can spread the cost of the Summer Camp over a year.

Film Camp Registration 11-17 - Residential

Name of Parent/Guardian * First Last
Mobile Number *
Maximum of 18 characters allowed. Currently Entered: 0 characters.
Alternative Number *
Maximum of 18 characters allowed. Currently Entered: 0 characters.
Email Address *
Home Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Name of Attendee * First Last
Attendee's Date of Birth * / DD / MM YYYY
Sex *
Child's Mobile number (for the purposes of communication on the camp only). Please leave blank if you do not wish to share.
Which week(s) is your child attending? *

Which week(s) is your child attending? Week 1 Week 2 Both weeks

Which areas are you most intererested in? *
	Not interested	Somewhat interested	Very interested
Acting and Improvising	Not interested	Somewhat interested	Very interested
Writing, Directing and Producing	Not interested	Somewhat interested	Very interested
Camera, Lights and Sound	Not interested	Somewhat interested	Very interested
Special FX Makeup	Not interested	Somewhat interested	Very interested
Costume and Set Design	Not interested	Somewhat interested	Very interested

Name of GP * First Last
GP Contact Number *
Maximum of 18 characters allowed. Currently Entered: 0 characters.
Does your child require Leeds-Bradford Airport or Apperley Bridge Station collection/return? We will arrange details closer to the camp date.

Does your child require Leeds-Bradford Airport or Apperley Bridge Station collection/return? We will arrange details closer to the camp date. No Yes
In order for us to provide our highest quality care and support for your child, we need to be informed of additional requirements for your child.
Additional room needs: for example, room sharing, named roommate, access requirements, private room (incurs additional charge). If none, please write "none". *
Dietary requirements, for example: vegetarian, halaal, food allergies. If none, please write “none”. *
Medical requirements, for example: medications, adverse reaction to medication, eczema, asthma, diagnoses or ongoing investigations. If none, please write “none”. *
Social, emotional and mental health, for example: counseling, behaviour management, history of anxiety or self harm. If none, please write “none”. *
Accessibility requirements, for example: wheelchair access, assistive devices or specific materials. If none, please write “none”. *
Additional school support your child has, or that you would like for your child, eg. learning support assistant, behaviour plan, coping strategies, additional learning materials or time. If none, please write “none”. *
In the event of an accident or emergency, I agree to a trained doctor examining and treating my child. *

In the event of an accident or emergency, I agree to a trained doctor examining and treating my child. I do not need to be present Only if I am present
I give my consent for ACT 2 CAM to make film, photograph and audio recordings (herein called “Media”) of my child at appropriate times, during my child's participation in the ACT 2 CAM course. *

I give my consent for ACT 2 CAM to make film, photograph and audio recordings (herein called “Media”) of my child at appropriate times, during my child's participation in the ACT 2 CAM course. I consent I do NOT consent
I give my consent for ACT 2 CAM to exhibit at organised events and exhibitions, and to distribute the edited Media to other teachers, parents and students on the course. *

I give my consent for ACT 2 CAM to exhibit at organised events and exhibitions, and to distribute the edited Media to other teachers, parents and students on the course. I consent I do NOT consent
I give my consent for ACT 2 CAM representatives to use the Media, on promotional materials, social media, press releases, and the ACT 2 CAM website, as they see fit. *

I give my consent for ACT 2 CAM representatives to use the Media, on promotional materials, social media, press releases, and the ACT 2 CAM website, as they see fit. I consent I do NOT consent
I give my consent for ACT 2 CAM to store this information, and contact me, in accordance with UK General Data Protection Regulation (GDPR) law, 2018. *

I give my consent for ACT 2 CAM to store this information, and contact me, in accordance with UK General Data Protection Regulation (GDPR) law, 2018. I consent I do NOT consent
I have read and understood ACT 2 CAM’s Terms & Conditions *
Agreed
I have read and understood ACT 2 CAM’s Code of Conduct *
Agreed
I have read and understood ACT 2 CAM’s Privacy Policy *
Agreed
How did you hear about us? *

How did you hear about us? Existing Member Internet search School Word of mouth Employer Advert Facebook Twitter Instagram Other Other
This document contains the full and complete understanding between myself and ACT 2 CAM. It supersedes all prior understandings and agreements between us and cannot be modified except by written agreement.
Draw your signature into the box below. *

Clear
Date of signing * / DD / MM YYYY

REGISTER FOR OUR RESIDENTIAL SUMMER CAMP

Film Camp Registration 11-17 - Residential

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