Junior School Application Form

Equality, Diversity and Widening Participation
Central School of Ballet is committed to addressing issues of under-representation in ballet and higher education. To achieve this, we identify and target prospective, talented students from groups that are currently under-represented, particularly including students:
- from low income backgrounds
- from postcodes where participation in higher education is low
- from under-represented ethnic backgrounds
- students classified as having a disability
In answering the questions below, and throughout this form, you will enable us to work towards ensuring talented dance students can access ballet and higher education. For further information about Widening Participation at Central School of Ballet please follow this here
Applicant's Details
First name*
Surname*
Address*
Post Code*
Date of Birth*
DD dash MM dash YYYY
Age*
Please enter a number from 3 to 18.
Current School Year*
Gender*

Emergency Contact Details
Name*
Relationship to the applicant*
Contact Telephone Number*
(Please provide a mobile telephone number if possible.)
Parent or Legal Guardian of Applicant: Parent 1
Title*
First Name*
Surname*
Email address*
Phone number*
- Correspondence to be addressed to this person.
Parent or Legal Guardian of Applicant: Parent 2
Title
First Name
Surname
Email address
Phone number
- Correspondence to be addressed to this person.
Collection Procedure
If your child is regularly brought or collected by another person, please provide their details here. Please note that an adult must remain in the building throughout the duration of the class for all children in Pre-Ballet to Level 2.
Are they
Name(s)
Telephone

Injuries & Medical Conditions
Please specify any ongoing medical conditions, allergies and recent injuries and relevant treatment.
Disclaimer*
- I understand that the information I provide on injuries and medical conditions will be processed by appropriate individuals only in accordance with access protocols (i.e. on a ‘need to know’ basis). I can withdraw my consent at any time by emailing juniorschool@csbschool.co.uk

Additional Needs & Resources
Will the applicant need additional support for any reason?*
- Yes
- No
If yes, please provide more details below:*
By informing us of any additional needs, this means that we can look at any extra support that is needed and make sure it is in place before your child starts class with us. This is to ensure they are safe, well cared for and most importantly happy in class. The support may be for health or medical requirements, learning difficulties or behaviour. These could include medical treatment, assessments by a speech and language therapist, medical staff, psychologist or psychiatrist and concerns about development or behaviour.

All information disclosed is confidential and will only be used to decide whether your child needs additional help or resources.

Photography Permission
Central School of Ballet may take photographs and/or film footage in classes which will be used at the discretion of Central School of Ballet, the Conservatoire for Dance and Drama and partner organisations on social media and future marketing campaigns. To comply with the General Data Protection Regulation (GDPR) and the Data Protection Act 2018, we need your permission before any images of the applicant (aged under 18) are taken. Please note, names of children will not be printed alongside photographs.
Please select one of the following*
- YES, I give permission for the applicant to be photographed and/or filmed during classes, and for the resulting images to be used by Central School of Ballet, the Conservatoire for Dance and Drama and partner organisations.
- NO, I do not give permission for the applicant to be photographed and/or filmed during classes, and for the resulting images to be used by Central School of Ballet, the Conservatoire for Dance and Drama and partner organisations.

Equality and Diversity Information
Ethnicity*
Disability*
Did either of the applicant's parents attend Higher Education?*
- I prefer not to say
- Yes
- No
Is the applicant, or has the applicant ever been, in local authority care?*
- I prefer not to say
- Yes
- No
Is the applicant estranged from their parents?*
Estrangement is defined as having not communicated with either of their biological or adoptive parents for the past 12 months and the situation is irreconcilable, or their parents cannot be traced, or it is not possible, practical, or safe to contact them or that their parents have significant mental or physical health problems which prevent the student from contacting them.
- I prefer not to say
- Yes
- No
Household Income*

Marketing Preference
Mailing List
If you would like to be contacted about future Widening Participation opportunities and events at Central School of Ballet, please tick one or both boxes to specify what you wish to receive. Please note that you must be aged 18 or over to receive emails from Central School of Ballet. (If you do not wish to receive emails regarding other opportunities, please leave these boxes blank. Please note that you will therefore only receive emails about courses for which you attend.)
- I would like to receive further details about Widening Participation opportunities at Central School of Ballet.
- I would like to hear more about Central School of Ballet and Ballet Central, including news, fundraising, forthcoming events and wider opportunities.
Please provide the email address where you would like to receive these updates*
Long-term evaluation
Central School of Ballet may wish to contact you to assess the long-term impact of our work. Do you consent to being contacted?*
- Yes
- No
Declaration
*
- Please tick this box to say you have read and agreed to the Data Processing Statement here
*
- I certify that to the best of my knowledge the information provided in this document is accurate at the time of writing. I accept that any amendment to the information provided after acceptance and acknowledgement of this application could result in the loss of a place. I have also read and understand the Payment and Refund Policy detailed here
*
- I confirm I give my explicit consent for the information I have provided in this form, including any information on injuries and medical conditions, to be processed by appropriate individuals only in accordance with access protocols. I can withdraw my consent at any time by emailing juniorschool@csbschool.co.uk
Once you click submit, you will receive an email confirming that we have received your application. If you do not see this confirmation in your emails, please check your junk/spam folder for an email from Central School of Ballet.
Parent / Carer Signature*

Step 1 of 8 – Applicant’s Details

Equality, Diversity and Widening Participation

Applicant's Details

Emergency Contact Details

Parent or Legal Guardian of Applicant: Parent 1

Parent or Legal Guardian of Applicant: Parent 2

Collection Procedure

Dance Training and Education Details

Injuries & Medical Conditions

Additional Needs & Resources

Photography Permission

Equality and Diversity Information

Marketing Preference

Long-term evaluation

Declaration