Summer Term Sign-up 2023 
Term starts Monday the 24th of April  
Half term 29th of May 
End of term sharing 17th of July 

Please complete the form below. 

In order to ensure the safety of all of our participants this form must be completed fully by all parents/guardians. By filling out this form you give permission for the London Borough of Hackney Youth Service to collect and store personal data about me and the activities which I participate in for monitoring purposes. I understand the data will be held in line with the Data Protection Act 1998 and subsequent updates and amendments.

Please fill out one form per participant.
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Participants first name  *
Participants Surname *
Participants age  *
Participants Gender *
D.O.B *
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7-10 Monday Dance -  4pm-5pm 
Clear selection
11-15 Monday Dance 5pm-6pm
Clear selection
15-19* Monday Creative Development 5-7pm 
Clear selection
10-14 Girls Group Tuesday 4:30pm - 6pm 
Clear selection
7-14 Wednesday Art 4pm-5pm 
Clear selection
12-17 Wednesday Young Leaders 5pm-6:30pm 
Clear selection
7-10 Thursday Drama 4pm-5pm 
Clear selection
11-16 Thursday Drama 5pm-6pm 
Clear selection
14-19 Saturday Music Studio Session 11am-4pm 
Clear selection
14-19* Weekday Music Studio sessions and Music Industry advice 
Clear selection
Please give details of any participant medical condition or allergies that it would be useful for us to be aware of (e.g. diabetes, epilepsy, asthma, hay fever etc)
Please give details of any special educational needs that it would be useful for us to be aware of
Parent/carer Name 
Parent/carer Contact number  *
Young Person Contact Number (14 above) 
Parent/Carer email address  *
Postal address line one 
postal address line two 
Postcode  *
I consent to the participant receiving first aid if necessary
*
Are they allowed to go home by themselves?
*
I consent to Hoxton Hall using images/video footage of the participant for promotional purposes, including flyers, posters, reports, press, media 
*
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