Names of Child/children:
1.
2.
3.
 Address:
Age/s:
1.
2.
3
 Phone number that you can be contacted in case
of emergency:
Learning Disability (if any) please give details:
 School:




Class:
Any physical illness that may affect your child’s
participation?
 Any concerns about your child e.g. shy, poor
socials skills etc.
DEVELOPMENTAL DRAMA SCHOOL
Deirdre Reddy M.A (Hons) Dramatherapist . I.A.C.A.T

REGISTRATION FORM
PLEASE ENSURE YOUR CHILD  WEARS COMFORTABLE CLOTHING

During the session photographs may be taken of enacted scenes.

I give permission to have my child photographed                  YES                        NO       

I do not give permission to have my child photographed        YES                       NO   
(PLEASE CIRCLE YOUR ANSWER)

Signed by parents/ guardian :         _________________________________

Please enclose cheque of € 120 for each child or  €120 for first child and each subsequent child €100 and return  
to ASAP:
Ms. D. Reddy, ‘Grange Wood’, Church Road, Kilmeany, Carlow.