Contact details and permission form

(please attach a recent passport sized photo)

Group (please circle): Mini (8-10 yrs)/ (Junior 11-13 yrs)/ Senior (14-18 yrs)

Name: DOB:

Name of contact parent/ carer:

Address including postcode:

Contact telephone number:

email address (if used regularly):

member’s school/college/job:

Emergency Contact Information

1st Name: Contact number:

2nd Name: Contact number:

3rd Name: Contact number:

Does the young person suffer from any medical conditions or allergies that we
should know about?:

Does the young person have any access needs or any areas in which they may
need support? (We will do everything we can to support young people in a group
environment but cannot provide one to one support):

Parent/ carer to complete: To the best of my knowledge the information contained

within this form and the permissions given are up to date.

Name:…………………………………. relationship to young person:………………

Signature……………………………….Date:………………………… PTO
Media Release
LYT and the Royal Lyceum Theatre Company take photographs and film footage of
young people in rehearsal and performance. These are used for items such as
programmes, posters for shows, the theatre’s brochure etc. This ONLY shows young
people in a positive light and is ONLY used to promote the work of LYT, the Royal
Lyceum Theatre Company and its partners. The images would ONLY be shared
between these named organizations and selected, relevant and reputable partners such
as the Scottish Arts Council.

Are you happy for us to take photographs/ film footage? Yes No

Casting
Casting directors for work in radio, TV & film regularly approach LYT. The Royal Lyceum
Theatre Company then show and pass on a photograph of your child and all of the
information contained in this form to casting directors if / when they contact us. LYT do
not guarantee professional opportunities and we do not actively seek work for our
members.

Please select if you would like your child to be put forward for such castings.
Yes No

Opportunities
We will always keep you updated about relevant projects and performance opportunities
happening through The Lyceum Youth Theatre. We sometimes share members’ details
with like minded organizations. This would only be if it offered a genuine opportunity to
our members such as workshops or projects and not for anything of a commercial
nature.

If you are happy for us to share your details ONLY in this way please select
Yes No
Please return to Christina Poulton, Youth Theatre Producer, Lyceum Youth Theatre, 30b
Grindlay Street, Edinburgh, EH3 9AX