COUNTY LIMERICK YOUTH THEATRE
Registration Form : PDF
(please use BLOCK CAPITALS)
Name: ______________________________
Address: ______________________________
______________________________
______________________________
______________________________
Age: _______________ Date of Birth: ____ /____ /____
Tel. No. (Home)__________________ (Mobile) ___________________
E-Mail: _________________________________
In case of emergency contact person and number __________________________
Any illness/allergies/disabilities we should be aware of? _______________________________
School: ________________________________Class Year: _______________
Country of birth: ______________________________ Year of arrival in Ireland: _________
Have you ever been involved in Theatre, Drama or Stage Productions:
Yes No
If yes give details: _________________________________________________________
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Hobbies/Interests/Musical ability:
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The Co LYT is an initiative of Limerick County Council. If you have any questions/queries please do not hesitate to contact us on 083 071 7162. By completing this information you are agreeing to be contacted with information pertaining to youth theatre and drama.