Standard child performance and activities licence application

The Children and Young Person Acts 1933 (opens in new window) and 1963 (opens in new window)

The Children (Performances and Activities) (England) Regulations 2014 (opens in new window)

Statement

Note: this form should be completed and submitted to Redbridge no less than 21 days before the first performance or activity for which the licence is requested. The licensing authority may otherwise refuse to grant a licence.

To submit this application you will need to upload a Medical Declaration form completed by the child's parent/carer.

You can download a Medical Declaration form and send it to child's parent/carer and then upload it to this application when complete. You can use "save & continue" button to complete application when ready.

To submit this application you will need to upload:

a copy of the child’s birth certificate
a photograph of the child taken during the last 6 months
Child Protection / Safeguarding Policy
Risk Assessment
Medical Declaration form
School permission (if performance/activity takes place during term time)
a copy of any other relevant documents (where they exist) containing details of the agreement regulating the child’s participation in the performance or activity to which this application relates

Any person who fails to observe any condition subject to which a licence is granted or knowingly or recklessly makes any false statement in connection with an application for a licence is liable to a fine not exceeding £1000 (level 3 on the standard scale) or imprisonment for a term not exceeding three months or both (section 40 of the Children and Young Persons Act 1963).

Please select(Required)

I have read and understood the above statement before continuing with this application

Information about Agent completing this form

Agent's first name(Required)

Agent's last name(Required)

Agent's email(Required)

Part 1: Information to be provided by the applicant about the performance or activities.

Applicant's details

Title

First name(Required)

Last name(Required)

Job title(Required)

Company(Required)

Company address(Required)

Address Line 1 Address Line 2 City County Postcode

Applicant's contact details

Telephone

Mobile number(Required)

Email(Required)

Child protection, safeguarding policy and risk assessment

Note: it is best practice that organisations that involve children in performances, paid modelling or paid sport have or develop a child protection policy, regularly review and update it, and ensure that all staff and volunteers are familiar with it.

Does your organisation have a child protection or safeguarding policy?(Required)

Yes

No

When was this last updated?(Required)

Please provide a copy of the policy(s):(Required)

By inserting a link

By uploading a copy of the document

Please provide link for a copy of the policy(s)(Required)

Please upload your policy(s)(Required)

Drop files here or

Max. file size: 50 MB.

Warning You can't progress with this application without child protection / safeguarding policy.

Have you completed a risk assessment?(Required)

Yes

No

Please provide a copy of the risk assessment(Required)

By inserting a link

By uploading a copy of the document

Please provide link for completed risk assessment(Required)

Please upload your completed risk assessment(Required)

Max. file size: 50 MB.

Warning You can't progress with this application without risk assessment.

Nature of the performance or activities

Name of production(Required)

E.g. theatrical, musical, dancing, filming, sport, modelling

Please provide a full description about what the child will actually be required to do. Include information about the working environment and any other contextual information that may help us in assessing the potential physical, emotional or psychological risks to the child(Required)

It is not necessary to provide a script – the description of the activity and context is more important.

Performance/activities and rehearsal location

Please provide details of performance/activities

Location of performance/activities	The dates and times of performances/activities	Is rehearsal address different from performance/activities address?	Location of rehearsal	Actions

There are no Entries.

If the dates and times are not currently known, please provide the number of days and the period during which it is requested that a child may take part in activities, performances or rehearsals.This might be because the filming schedule cannot be fixed in advance, or the activity is dependent on weather conditions.

The expected total running time or duration of activities / performances (including any rehearsal)(Required)

The approximate duration of the child’s appearance in the performance / activity(Required)

Please provide details about the amount of night work (if any) for which approval is being sought

Will performance include night work?(Required)

Yes

No

The approximate number of days(Required)

For these purposes any performance taking place after midnight and before the earliest permitted hour counts as an extension to the previous day. E.g. if the child performs on Tuesday and then performs after midnight, in the early hours of Wednesday, that counts as one day (Tuesday)

Please enter a number greater than or equal to 1.

The approximate duration on each day(Required)

The reason that the performance must take the form of night work(Required)

We ask for assurance that there is a good reason why the child is asked to take part in a performance or activity at night

Details about the sums to be earned

The sums to be earned by the child in taking part in the performance or activity(Required)

Will sums to be paid directly to the child in question?(Required)

Yes

No

Please provide name of the person sums will be paid to(Required)

Address of the person(Required)

Address Line 1 Address Line 2 City County Postcode

Description of the person(Required)

i.e. if it is an individual what is their relationship to the child, or is it a company or organisation and if so, what is their relationship to the child?

Requested absence from school

The days or half days on which leave of absence from school is requested(Required)

Please provide details about proposed arrangements (if any) for the education of the child during the period for which the licence is requested

Are there arrangements made for the education of the child during the period for which the licence is requested?(Required)

Yes

No

Is the education to be provided by a school?(Required)

Yes

By someone else

Details of education provider

School name(Required)

School address(Required)

Address Line 2 Address Line 2 City County Postcode

Name of the proposed teacher(Required)

Address of the proposed teacher(Required)

Address Line 2 Address Line 2 City County Postcode

Qualification of the proposed teacher(Required)

Details of education provider

The place where the child will be taught(Required)

The proposed course of study(Required)

The number of other children to be taught at the same time by the same teacher and the sex and age of each child(Required)

Will the child receive the amount of education in accordance with regulation 13(3)(e) of the Children (Performances and Activities) (England) Regulations 2014(Required)

The Children (Performances and Activities) (England) Regulations 2014 (opens in new tab)

Yes

No

Will the parent act as a chaperone(Required)

Yes

No

Chaperone details

Parent's name(Required)

Parent's email(Required)

Parent's address(Required)

Address Line 2 Address Line 2 City County Postcode

Name of proposed chaperone(Required)

Name of the Local Authority where the chaperone has been approved(Required)

Licences expiry date(Required)

Please upload a copy of a licence

Max. file size: 50 MB.

Details about accommodation and children in the care of the Chaperone during performance/activity

How many children will be in the care of the Chaperone during this performance/activity? Please state Sex and age of each child(Required)

The address of any accommodation where the child will live, if different from the place where the child would ordinarily live, the number of other children and details of the chaperone (if any) who will live in the same accommodation(Required)

Details about travel to place of performance

Approximate length of time which the child will spend travelling to and from the place of performance, rehearsal or activity each day(Required)

Arrangements (if any) for transport there

Arrangements (if any) for transport back

Details of any other applications for another child to any other Local Authority

The name of any other local authority, or in Scotland, any education authority to which an application has been made for another child to take part in performances or activities to which the application relates (if not known at the time of application, to be provided when known)

This will help the relevant local authorities to take a consistent approach

Part 2: Information to be provided by the applicant in relation to the child.

Child's details

Child’s first name(Required)

Child’s last name(Required)

Child’s date of birth(Required)

Child's details

Child’s address(Required)

Address Line 2 Address Line 2 City County Postcode

Child’s parent/guardian name(Required)

Child’s parent/guardian email(Required)

Does the child currently attend school?(Required)

Yes

No

Child has not yet started Reception

School details

School name(Required)

School address(Required)

Address Line 2 Address Line 2 City County Postcode

Private teacher's name(Required)

Private teacher's address(Required)

Address Line 2 Address Line 2 City County Postcode

Licence details in relation to the child

Please give details of each licence in relation to the child granted during the twelve months preceding the date of the application by any local authority, or in Scotland, any education authority, other than the licensing authority to which this application is made

This will only be relevant if the child has moved between authorities in the last 12 months

The name of the authority

The date the licence was granted

The dates and nature of performances or activities

Application details in relation to the child where the licence was refused

Please give details of each application in relation to the child for a licence refused by any other authority in the last 12 months, other than the licensing authority to which this application is made

The name of the local authority or education authority

The reasons (if known) for the refusal to grant a licence

Details of performances for which a licence was not required

Please give details of any performances for which a licence was not required in which the child took part during the previous 12 months

By virtue of section 37(3) of the Children and Young Persons Act 1963 (opens in new window)

The date of the performance

The number of days of performance

Please enter a number greater than or equal to 0.

The title of the performance

The name of the person responsible for the production

The address of the person responsible for the production

Address Line 2 Address Line 2 City County Postcode

School absence details

Dates (if any) on which the child has been absent from school during the twelve months preceding the date of the application by reason of taking part in a performance or activity

Amount of any monies earned by the child during the last twelve months, stating whether the monies earned were in respect of performances or activities for which a licence was granted or a performance for which a licence was not required

Medical declaration and school permission form

Medical declaration to be completed by child’s parent/carer

You need to download Medical Declaration form send child's parent and then upload it to this application.

Please upload medical declaration form completed by child’s parent/carer(Required)

Max. file size: 50 MB.

Please upload school permission form(Required)

Max. file size: 50 MB.

Required documents

Please upload a copy of the child’s birth certificate/passport(Required)

Max. file size: 50 MB.

Please upload a photograph of the child taken during the last 6 months(Required)

The image must not be altered or enhanced in anyway. It should be a full head shot taken in good light

Max. file size: 50 MB.

A copy of any other relevant documents (where they exist) containing details of the agreement regulating the child’s participation in the performance or activity to which this application relates

Drop files here or

Max. file size: 50 MB.

Please write your full name(Required)

Email address (Agent)(Required)