Come to the Movies application

Name:  *

Age:  *

Date of Birth:  *

Address:  *

Emergency Contact name 1:  *

Emergency Contact number 1:  *

Emergency Contact name 2:  *

Emergency Contact number 2:  *

Email Address:  *

School/College:  *

Are there any medical conditions/learning disabilities we should know about?:  Yes
No *

Medical Information: 

Permission is even for me/my child to be photographed/filmed, which may be used for promotion/publicity purposes:  Yes
No *

Permission is given to keep the above information on our files until the end of the Summer Project. I have read the Company's Data Protection Policy. :  Yes
No *