Streetwise Youth Circus - Friday 6pm (8 - 14yo) class registration 2025/6
September 2025 - June 2026 contact details and consent.
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Young person's name: *
Date of birth: *
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Current school year *
Does the young person have any medical conditions or allergies? *
Does the young person have any other needs it would be useful for us to be aware of? *
Emergency contact #1 (parent/guardian name and relationship): *
Emergency contact phone number #1: *
I/ we give permission for the young person named above to participate in Streetwise Circus skills workshops, including stiltwalking, unicycling, juggling, trapeze etc. *
I/ we give permission for Streetwise to provide First Aid to the workshop participant if necessary. *
I/ we give permission for Streetwise to provide plasters to the workshop participant. *
I/ we give permission for Streetwise to take and use photographs/ video for workshop promotion: *
Are you happy for us to add you to a WhatsApp group for Youth Circus announcements? *
Emergency contact #2 (name and relationship): *
Emergency contact phone number #2: *
By filling in this form, you are consenting to the young person participating in Streetwise Youth Circus workshops, and that all the information provided above is correct to the best of your knowledge (under 18s please have a guardian complete).
Please type your name below: *
Additional information:
This is to help us plan ahead and is not necessary for your young person's involvement.
Is your young person interested in participating in additional Circus activities outside of regular Friday evening workshops?
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If your young person is interested in more learning opportunities outside of regular workshops, what skills interest them?
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If your young person is interested in more learning opportunities outside of regular workshops, how regularly would they be able to participate in these?
Clear selection
Is your young person interested in performance opportunities?
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Would your young person be interested in going to see Circus performances as a Youth Circus outing?
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Would your young person interested in visiting other Youth Circuses for exchange projects?
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Final question! 
Are you, the grown up/ responsible adult/ parent/ guardian interested in learning circus? If so, what skills interest you?
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