SummerStage Booking Form 2018: WEEK 1

Monday 29th July – Friday 2nd August 2019

Week 1 is for young people who are new to taking part in drama projects. We welcome young people who might have mild-moderate learning needs or require special access arrangements. During this SummerStage week participants will focus on developing skills such as confidence, creativity and communication! Participants will also work on a Bronze Arts Award which is a fun and useful qualification.

SummerStage 2019 will take place at The Forum Hall of Bloomsbury Central Baptist Church, 235 Shaftesbury Avenue, LONDON WC2 H8EP.

Each day will run from 10.00am to 4.00pm.

SummerStage costs £60 per participant (inclusive of 5 day workshops, a sandwich lunch each day and a visit to a see a show in the West End). There are also 4 scholarship places available, please indicate below if you would like to be considered for one of these.

Name of Participant *

First Name Last Name

Date of Birth of participant *

Day Month Year Date Picker Icon

Phone Number of participant

Area Code Phone Number

Name of Parent/Guardian *

First Name Last Name

Phone Number of Parent/Guardian *

Area Code Phone Number

E-mail of Parent/Guardian

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Name of school/college that the participant attends (if applicable)

Please confirm that you are applying for SummerStage Inclusive Week 1: *

Monday 29th July – Friday 2nd August 2019

Does your child have any learning difficulties? If yes, please describe below.

Does your child have any access requirements (e.g. need step-free access or a wheelchair space for the theatre visit). If yes, please detail below and if you would like to discuss this further, please call Gemma Bell (Youth Engagement Manager) on 020 7632 4122.

Does your child have any health issues or allergies? Please specify any medicine your child will be carrying (e.g. inhalers or Epipens). Lunch will be provided - let us know anything your child can't eat:

Exceptions to Attendance

As SummerStage will work towards a performance, commitment is necessary for us to allocate roles. In addition, for the safety of your child we request advance notice if your child is unable to attend certain days. Once on the project if your child is unable to attend certain days please contact the above name/number asap so that we do not worry about their safety and so that we can adapt the rehearsal schedule (or if it’s a trip day refund the cost of their ticket so as to not lose any money).

IMPORTANT INFORMATION

In order for your child to take part in SummerStage, you must ensure that they have the following with them:

- Suitable loose and comfortable clothing (no jeans and no jewellery whilst dancing).

- Suitable footwear (trainers, dance shoes, or bare feet).

- Snacks and refreshments to sustain them throughout the day (preferably water).

- Packed lunch if they wish to eat their own food (sandwiches will be provided. Young people will not be permitted to leave the building during the programme unless otherwise specified - see below).

Additional consent is required in order for your child to leave the premises during the lunch break each day. Do you give your consent for your child to leave the premises at lunch time each day? *

Yes No

If your child is unable to find their way to the SummerStage venue, a member of the Mousetrap Theatre Projects staff team will be able to collect them from Tottenham Court Road tube station and escort them to/from the venue. THIS SERVICE WILL ONLY BE AVAILABLE IF ARRANGED IN ADVANCE. Please indicate below whether you will be requiring this service, and we will contact you to confirm arrangements: *

Yes No

Parental consent is required in order for your child to attend SummerStage. By signing this consent form you are consenting to:

- My child to take part in Mousetrap performing arts summer project in its entireity, including a trip to the theatre.

- My child to appear in photographs or video footage taken by Mousetrap for use in the public domain to promote the programme.

- Mousetrap to use quotes and/or anecdotal stories given by my child for use in the public domain to promote the programme.

Please indicate below whether you give consent for your child to attend this event:

I give my consent to all the above conditions: *

Yes No

Would you like to be considered for a fully-funded scholarship place? If yes, this will be discussed over the phone. (Please note that these places are for young people and their families who find the cost of £60 prohibitive and otherwise would not be able to take part in the project.) *

Yes No

In your own words, please briefly describe how this fully-funded scholarship place will benefit you?

And finally, how did you hear about SummerStage? *

Your Privacy:

To view our privacy policy please click here

IF YOU SELECT NO TO BOTH OF THESE QUESTIONS BELOW, YOU WILL NO LONGER HEAR FROM US BY EMAIL

You are happy to receive future information about the Summerstage programme from us via email

Yes No

You are happy to receive emails from us (approx. once a year) about other Mousetrap opportunities, events, areas of support, e.g. ways you can help Mousetrap like casting your vote for us to win an award

Yes No

Please click submit to apply for SummerStage!
Gemma will be in touch with you to discuss your application and, if successful, confirm your place and take payment in the next couple of weeks.
Thank you for your patience - we receive lots of applications!

SummerStage Inclusive Application Form

Consent