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The Young Performers Database
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INDIVIDUALS 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
(contact
person)____________________________ and they have read and understood our disclaimer
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:
(reminder - Contact Persons form - registration page for what to do next)
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