Level Makes Registration Form

Please complete this form and a member of the LEVEL team will be in touch to make sure the sessions are right for the participant. If you have any queries, please contact info@levelcentre.com for more information.

Participant's Details

Participant's Name *

Street Name *

House name/number

City

Postal Code

Country

About the Participant

Does the participant have any access requirements? *

YesNo

Main Contact Details

Please complete if different to participant's details

Main contact name

Main contact phone number

Email address of main contact *

Emergency Contact Details

Please complete if different to main contact's details

Emergency contact name

Emergency contact phone number *

Relationship of emergency contact to participant

Choose your Sessions

Please select which sessions you would like to book

LEVEL Makes: Performance - 6 week block £120LEVEL Makes: Visual Art - 6 week block £120LEVEL Makes: Performance Online - 6 Week Block £30Level Makes: Sensory Play - £5 per session

Total

Photo and Video Consent

Are you happy to appear in photos and videos that promote LEVEL? *

YesNoWe celebrate, promote and document the work of LEVEL through still images and video recordings. By ticking 'Yes' you agree to your image being used.

GDPR

GDPR *Yes, I agree with the privacy policy and terms and conditions.

Payment

Please pay in advance of the sessions. You can pay by PayPal or request an invoice.

How would you like to pay?

PayPalInvoice

If you would like an invoice, please let us know the best email address to send it to

Level Makes Registration Form