Online registration form for PH2Youth
Use this form to register with PH2Youth. You will receive an email with your submission details after registration.
Contact details
First name
Please enter your first name.
Last name
Please enter your last name.
Email
Please enter a valid email address.
Mobile
Phone
Additional notes
Show address fields
Address
City
County or region
Postcode
Country
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, Republic Of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Barthelemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French Part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch Part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Children
Child's first name
Child's last name
DOB
Medical notes
Parental issues
Yes
No
Are there any parental issues that we should be made aware of?
If yes, please speak in confidence to a member of PH2Youth Management
Additional Emergency Contacts:
Emergency Contact 2 - Name *
Emergency Contact 2 - Number *
Emergency Contact 2 - Relation to Student *
Emergency Contact 3 - Name
Emergency Contact 3 - Number
Emergency Contact 3 - Relation to Student
Parental Permissions:
A. Make their own way home *
Yes
No
Do you agree to allow the student to make their own way to and from the site at the beginning and end of the session?
B. Leave during session *
Yes
No
Do you agree to allow the student to leave during the session at any time without adult supervision?
C. Purchase soft drinks and snacks *
Yes
No
Do you agree to allow the student to purchase soft drinks and snacks at break times if they wish to?
IMPORTANT: If you have answered ‘no’ to question ‘a’, the student will not be allowed to leave the site at the end of the session until you or a nominated person collects them. Please list below all nominated persons who may collect the student THAT HAVE NOT ALREADY BEEN NAMED IN EMERGENCY CONTACTS:
Nominated Collection - Person 1
Please specify name, number and relation to student.
Nominated Collection - Person 2
Please specify name, number and relation to student.
Nominated Collection - Person 3
Please specify name, number and relation to student.
Policies and Consent:
Photography Consent
There may be opportunities for the student to be photographed for use in the theatre, newspapers and social media etc. Strict child protection guidelines will be adhered to. Please tick the checkbox above If you AGREE for your child to be photographed.
Filming Consent
There may be opportunities for the student to be filmed for use in the theatre, newspapers, promotional videos and social media etc. Strict child protection guidelines will be adhered to. Please tick the checkbox above If you AGREE for your child to be filmed.
Disclaimer *
Please tick the checkbox above to confirm that you have read, understood and agree to the following:
• The student is responsible for any items of clothing or other possessions they may bring to the sessions. PH2Youth staff and volunteers are unable to look after participant’s belongings. PH2Youth will not take responsibility for the loss of or damage to any personal equipment or belongings that are brought to the workshops.
• Hot beverages, soft drinks and snacks will be on sale during the workshops for students and parents/guardians/carers wishing to stay during the session. Alcohol will not be sold during these sessions. The bar area will be out of bounds and any unauthorized personnel found behind the bar will be asked to leave the building and may be asked to leave the course.
• Workshops missed for sickness or holidays cannot be reimbursed. We reserve the right to cancel a workshop due to unforeseen circumstances. In the event of a cancellation you will be contacted as soon as possible and reimbursed accordingly.
• Students must be collected promptly after each session. Failure to do so may incur an additional charge.
Mobile Phone Policy *
Please tick the checkbox above to confirm that you have read, understood and agree to the following statement:
Mobile phones will not be allowed during any part of the workshop. If phones are seen to be used (unless in the case of an emergency) they will be confiscated and kept in a safe place until the end of the workshop.
Consent *
Please tick the checkbox above to confirm that you have read, understood and agree to the following statement:
I understand that by completing and submitting this form I am agreeing to my child participating in the relevant activity. I am agreeing to the disclaimer and mobile phone rule laid out above and I agree to pay the fees promptly on receipt of the invoice. Furthermore, I understand that should medical treatment be necessary, every reasonable effort will be made to obtain my consent. However, in an emergency I authorise a member of the PH2Youth Management to consent on my behalf to any medical treatment which a qualified clinician feels is necessary (this could include inoculations, blood transfusions, surgery or other anaesthetic).
Notes
Add a child
Child's first name
Child's last name
DOB
Medical notes
Parental issues
Yes
No
Are there any parental issues that we should be made aware of?
If yes, please speak in confidence to a member of PH2Youth Management
Additional Emergency Contacts:
Emergency Contact 2 - Name *
Emergency Contact 2 - Number *
Emergency Contact 2 - Relation to Student *
Emergency Contact 3 - Name
Emergency Contact 3 - Number
Emergency Contact 3 - Relation to Student
Parental Permissions:
A. Make their own way home *
Yes
No
Do you agree to allow the student to make their own way to and from the site at the beginning and end of the session?
B. Leave during session *
Yes
No
Do you agree to allow the student to leave during the session at any time without adult supervision?
C. Purchase soft drinks and snacks *
Yes
No
Do you agree to allow the student to purchase soft drinks and snacks at break times if they wish to?
IMPORTANT: If you have answered ‘no’ to question ‘a’, the student will not be allowed to leave the site at the end of the session until you or a nominated person collects them. Please list below all nominated persons who may collect the student THAT HAVE NOT ALREADY BEEN NAMED IN EMERGENCY CONTACTS:
Nominated Collection - Person 1
Please specify name, number and relation to student.
Nominated Collection - Person 2
Please specify name, number and relation to student.
Nominated Collection - Person 3
Please specify name, number and relation to student.
Policies and Consent:
Photography Consent
There may be opportunities for the student to be photographed for use in the theatre, newspapers and social media etc. Strict child protection guidelines will be adhered to. Please tick the checkbox above If you AGREE for your child to be photographed.
Filming Consent
There may be opportunities for the student to be filmed for use in the theatre, newspapers, promotional videos and social media etc. Strict child protection guidelines will be adhered to. Please tick the checkbox above If you AGREE for your child to be filmed.
Disclaimer *
Please tick the checkbox above to confirm that you have read, understood and agree to the following:
• The student is responsible for any items of clothing or other possessions they may bring to the sessions. PH2Youth staff and volunteers are unable to look after participant’s belongings. PH2Youth will not take responsibility for the loss of or damage to any personal equipment or belongings that are brought to the workshops.
• Hot beverages, soft drinks and snacks will be on sale during the workshops for students and parents/guardians/carers wishing to stay during the session. Alcohol will not be sold during these sessions. The bar area will be out of bounds and any unauthorized personnel found behind the bar will be asked to leave the building and may be asked to leave the course.
• Workshops missed for sickness or holidays cannot be reimbursed. We reserve the right to cancel a workshop due to unforeseen circumstances. In the event of a cancellation you will be contacted as soon as possible and reimbursed accordingly.
• Students must be collected promptly after each session. Failure to do so may incur an additional charge.
Mobile Phone Policy *
Please tick the checkbox above to confirm that you have read, understood and agree to the following statement:
Mobile phones will not be allowed during any part of the workshop. If phones are seen to be used (unless in the case of an emergency) they will be confiscated and kept in a safe place until the end of the workshop.
Consent *
Please tick the checkbox above to confirm that you have read, understood and agree to the following statement:
I understand that by completing and submitting this form I am agreeing to my child participating in the relevant activity. I am agreeing to the disclaimer and mobile phone rule laid out above and I agree to pay the fees promptly on receipt of the invoice. Furthermore, I understand that should medical treatment be necessary, every reasonable effort will be made to obtain my consent. However, in an emergency I authorise a member of the PH2Youth Management to consent on my behalf to any medical treatment which a qualified clinician feels is necessary (this could include inoculations, blood transfusions, surgery or other anaesthetic).
Notes