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The Young Performers Database 

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CONTACT PERSON FORM

Please print this page and fill out all sections - please not that it must be filled out by a parent or guardian

Please fill in using a Black Pen and in Block Capital letters:

Agent / Contact Persons Name:

Address: (this is for office use only and not to be printed)

Location:

Contact Telephone Numbers       Landline:

                                                    Mobile :

Email:

Website:

(On your contact page your website address can be linked to help promote your group and class)

Must Be Signed By The Agent / Contact Person ONLY!

I understand by signing this form that I take full responsibility for the booking / payment / fees in accordance with the work the child undertakes.

I also agree to the above information (not personal address) and a photo of myself to be displayed on the website.

Signature:                                                          Date:         

(reminder - Contact Persons form - registration page for what to do next)

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