POSW Sign-Up Form | The Music Box

First Name (Student)

Last name (Student)

Date of birth:

Month

Day

Year

Parent Name

Parent Phone Number

Second Emergency Contact Name:

Second Emergency Contact Number

Does the student have any medical conditions? (eg. allergies/dyslexia)

Yes

If you answered YES to the above, please provide details, (including any medication carried and adminsitration details).

I consent to qualified first aid staff providing necessary treatment, and, if necessary, medical care from emergency services.

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Our media policy protects children's identity and privacy. Please choose one option: Photography and/or filming

Yes, my child may be photographed or videoed for event archives/internal use only

Yes, my child may appear in public-facing images/videos

No, I do not consent to any images/videos.

Data Protection & Privacy

All information is stored securely under UK GDPR. Only designated safeguarding leaders, chaperones and first aiders will have access. Parents may request to review or amend information at any time.

Confirmation: By signing below, I confirm that information is accurate and I consent to its use in accordance with the privacy statement.

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Date

Month

Day

Year