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• First Name ^*

  Please enter the cast members first name
• Middle Name/s

  Please enter the cast members middle names
• Surname ^*

  Please enter the cast members surname
• Date of Birth ^*

  Please enter as YYYY-MM-DD
• Address Line 1 ^*

  Please enter your residential address
• Address Line 2
• Town ^*
• County ^*
• Postcode ^*
• Home Phone Number

  Please provide your home phone number
• Mobile Phone Number

  Please provide your mobile phone number
• Are you in the Scout or Guide Association? ^*

  Please select

  - please select -Scout AssociationGuide Association
• Please provide the name of your Group ^*

  This is the group that you are registered with and pay capitation through
• Please select your Scout District or Guide Division ^*
  - please select -Guide - Castle PointGuide - RayleighGuide - Southend EastGuide - Southend WestScout - Castle PointScout - Crouch ValleyScout - Southend EstuaryScout - Southend WestDon't Know
• Leader's Name ^*

  Please provide the name of your Leader. Please note, we will contact your leader in advance to confirm you are an active member of the Scouting/Guiding movement.
• Leaders Contact Details ^*

  Please provide a contact number for your leader.
• Leaders Email Address ^*

  Please provide a contact email for your leader. If unknown please enter N/A
• Do you wish to be in the Main Gang, Junior Gang or Band? ^*

  Main Gang must be in Year 8 or above and Junior Gang must be in Year 6 or 7. To be in the band, you have to be qualified to Level 5

  - please select -Main GangJunior GangBand
• Which instrument and at what level do you play?

  For Band Applicants only
• Emergency Contact Name #1 ^*

  Please provide an emergency contact name
• Emergency Contact's Relationship to You ^*

  Please select your emergency contact's relationship to you

  - please select -MotherFatherGuardianPartnerSiblingFriendOther

  Please specify: ^*
• Emergency Contact Number ^*

  Please provide a contact number for them
• Emergency Contact Name #2 ^*

  Please provide an emergency contact name
• Emergency Contact's Relationship to You ^*

  Please select your emergency contact's relationship to you

  - please select -MotherFatherGuardianPartnerSiblingFriendOther

  Please specify: ^*
• Emergency Contact Number ^*

  Please provide a contact number for them
• Which School or College do you attend?

  If Applicable
• Which School Year are you in (on 6th Oct 2019)? ^*

  To be in the Main Gang, you have to be in School Year 8 or higher on 6th Oct 2019. To be in Junior Gang, you must be in Year 6 or 7.

  - please select -67891011Sixth FormHigher EducationI am no longer in education
• Are you new to Southend Gang Show? ^*

  Will this be your 1st show with Southend Gang Show (This does not include SHINDIGS)

  Yes No
• Please provide details of any special skills or talents you have

  For Main Cast Applicants only i.e. singing, acting, dancing, circus skills, acrobatics, magic etc.
• Does your family have expertise or contacts in any of these areas that are willing to help the Gang Show?

  Please select any that you can help with

  Costumes (sewing etc) Graphic design Scenic artist Item storage Marketing Media (TV, Radio, Papers etc) Theatre skills Transportation Other

  Please specify:
• I confirm I have checked the dates on the Rehearsal Schedule
  Yes No
• Please select the commitment you can provide to rehearsals ^*

  Main Cast/Junior Gang members who do not select Full Commitment cannot be guaranteed a place in the show. People missing rehearsals may be accepted for a reduced role in the show. Band need to be able to commit to all Friday rehearsals and Sundays the same as the main gang.

  - please select -Cast - Full Commitment, I will not miss any rehearsalsCast - I can only attend Friday rehearsalsCast - I can only attend Sunday rehearsalsBand - Full Commitment, I will not miss any rehearsalsBand - I can only attend Friday rehearsalsBand - I can only attend Sunday rehearsals
• I am available and committed to Show Week ^*

  I confirm I am available for all rehearsals and performances at the theatre and the prior 2 Sunday rehearsals (Sun 2nd Feb & Sunday 9th Feb, Mon 17th - Sat 22nd Feb 2020 Feb Half Term)

  Yes No
• I have read and will abide by the code of conduct ^*
  Yes No
• If under 18 (on 22nd February 2020) - Please provide the first name of your Parent / Guardian ^*

  All under 18's need Parents / Guardians permission to be involved in the show you and the person named will be asked to sign a copy of this information. If over 18, please type N/A
• If under 18 - Please provide the surname of your Parent / Guardian
• If under 18 - Please select this persons relationship to you
  - please select -MotherFatherLegal GuardianOther

  Please specify:
• If under 18 - Please provide your Parent / Guardians E-mail address

  We will only use this to contact parents regarding the show and we will not pass on these details to any other party
• If under 18 - Please provide your parent's / guardian's contact number
• If Under 18 - Please ask your parent to confirm their consent to you being involved in the show

  Parents will also be asked to sign a copy of this information before you are accepted in the show.

  - please select -YesNoN/A
• If under 18 - Please consent to us contacting your children via e-mail and social media

  We will need to send out details of rehearsals and other GS related information. We will not disclose your child's contact details to anybody and all communication will be from approved members of GS staff

  - please select -YesNoN/A
• If under 18 - Your parent has to give consent for your image to be used

  You need to provide consent for you child's image to be used in the programme, publicity shots, social media, online publications and post-show photo / DVD sales knowing that the child's name will not be identified to the image.

  - please select -YesNoN/A
• If over 18 - I consent for my image to be used

  You need to provide consent for you child's image to be used in the programme, publicity shots, social media, online publications and post-show photo / DVD sales knowing that the child's name will not be identified to the image.

  - please select -YesNoN/A
• Please specify your GP's Surgery Name ^*
• Please specify your GP's surgery contact number ^*
• Please provide your GP's surgery address ^*
• Please notify us of any allergies you have ^*

  Please provide as much information as possible. Please state N/A if none.
• Please notify us of any illnesses or disabilities (including access & special educational needs) you have ^*

  Please provide as much information as possible. Please state N/A if none.
• Please notify us if you are currently receiving any medical treatment (within the last 6 months) ^*

  Please provide as much information as possible. Please state N/A if none.
• Please notify us of any medication you are currently taking ^*

  Please provide as much information as possible. Please state N/A if none.
• Please notify us of anything we should be aware of

  Please provide as much information as possible. Please state N/A if none.
• Person paying Gift Aid please select your title

  Required for Gift Aid Registration

  - please select -MrMrsMissMs.Dr.Other

  Please specify:
• Parents or Cast Over 18 - Please can we claim gift aid on your donations.

  I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.

  Yes No
• How did you hear about Gang Show 2020? ^*

  Please fill out how you heard about taking part in Gang Show 2020?

  - please select -RoadshowsFlyersFriend or FamilyGang ShowJunior GangMy Scout/Guide GroupFacebookTwitterSouthend Gang Show WebsiteEmailI am a Former Cast MemberOther

  Please specify: ^*