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The Young Performers Database 

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GROUP 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:

 

Part One - under 16s Permission 

Parent / guardian name:_________________________________

I understand by signing this form that I give permission to JUK Media Services Group, to place a head & shoulders photo 

and the information given about my child, onto their website & promotional material in order to put him/her 

forward for castings and work within the entertainment industry.

JUK Media Services Group will run the website but are not an agency, all agency responsibilities will be undertaken by 

(the agent / or contact person)____________________________

Please note that they as the agent will deduct their own fee at a rate of ______, which you agree to by signing this form.

A fee of £10.00 per child will go to JUK Media Services for the following services:

1 – Inclusion to the website until the child hits their 16th Birthday.

2 - The payment is to cover the uploading of photos, running of the website & costs with promotion and advertising of the site. 

3 - Up dating of your advert as needed

I agree and wish my child to be added to the website:

Name:___________________________________         Contact number:______________________

 

Signature: ________________________________       Date: ________________________________

 

Part Two - Performers Information

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

Name:

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

 

Postcode:                                                  Contact telephone number: (not to be printed)

 

D/O/B:                                                      AGE:                                                  Male / Female:

Height:                                                      Build:                                                  Eyes:                            Hair colour:

Three Credits:    1 -

                            2 -

                            3 -

Tick what they would like to do

All TV acting including extra work:                 Theatre:                     Radio:             Voice-overs:         Dancing:        Promotional work:

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

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