Application For Children's Entertainment Licence

APPLICATION FOR CHILDREN’S ENTERTAINMENT LICENCE
Children and Young Persons Act 1963
The Children (Performances) Regulations Act 1968
Section A is to be completed by the applicant (the Producer of the Performance)
1. I hereby apply for a licence under section 37 of the Children and Young Persons Act
1963, authorising the child to:
NAME OF CHILD:
a) take part in performances on the dates specified in 4(i) of the annexe to this section
or
b) take part in performances on the number of days and during the period specified in item 4(ii)
of the annexe to this section
Please tick box a or b
2. I certify that to the best of my knowledge the particulars contained in the annex to this
section are correct
3. I attach the followings:
a) the child’s birth certificate or proof of age
b) two identical (unmounted) passport sized photographs taken of the child in the past
six months
c) a copy of the contract, draft contract or other documents containing particulars of
that agreement regulating the child’s appearance in the performance
d) a letter from the Head teacher of the child’s school, giving permission for the child
to participate, and if necessary, to be absent from school
e) a note from a doctor confirming the child is fit to take part in the performance
Please tick boxes to confirm that items have been attached
Please provide the following details and sign the declaration:
Name of applicant:
Address:
Telephone number:
Mobile:
Occupation:
Signature:
Date:

Note: Any person who fails to observe any condition to which a licence is granted
or knowingly or recklessly makes any false statement in or in connection with an
application for a licence is liable to a fine not exceeding level 3 on the standard
scale (currently £1000) or imprisonment for a term not exceeding three months or
both (section 40 of the Children and Young Persons Act 1963)
SECTION A. PARTICULARS CONNECTED WITH THE PERFORMANCE - TO BE
COMPLETED BY THE APPLICANT
1. Name and nature of the performance (theatrical, film, television Etc.)
2. Description of the child’s part
3. Place of the performance, including any location work
4. i) the dates of performances OR ii) The total number of days, and the period
during which they are requested
5. Time and duration of the performances
6. Approximate duration of the child’s appearance in the performance
7. The amount of night work (if any) stating the number of days and duration of
each day
8. The sums to be earned by the child taking part in the performance

9. Proposed arrangements for rehearsals taking place in the fourteen days
preceding the first performance, stating date, place and duration
10. The days or half days for which leave of absence is requested to allow the child
to take part in the performance
11. Proposed arrangements (if any) for the education of the child during the period
for which the licence is requested, stating either:
i) The name and address of the school, OR
ii) Name of the private tutor, place of tuition, proposed course of
study, number of other children to be taught at the same time and
age and gender of each such child
12. The name of the Local Authority (if any) which has previously appointed the
private tutor
13. The name, address and description of the proposed matron (Matron must be
Police Cleared and proof of registration provided)
14. The name of the Local Authority (if any), which has previously approved the
appointment of the matron for the purpose of a licence
15. The number of other children to be in the charge of the matron during the time
when she would be in charge of the child in respect of whom this application is
made, also the age and gender of such child

16. If the child has to live somewhere other than his/her usual residence, please
state: the address of any lodgings, name of householder and the number of other
children who will live at the same lodgings:
17. Approximate length of time the child will spend travelling:
i) to and from the place of performance or rehearsal, and the arrangements of
any for transport
ii) ii) to and from the place of performance or rehearsal
18. Name of any other licensing authority to which an application has been made
for another child to take part in performances to which this application relates
Section B – to be completed by Parent or Guardian
Please give the following particulars in respect of the child
1. Name of the child:
2. Date of birth of the child:
3. Address of the child:
4. Name and address of schools attended by the child during the twelve months
preceding the date of this application
5. Dates (if any) on which the child has been absent from school during the past
twelve months due to him/her taking part in a performance

6. Particulars of each application for a licence made during the past twelve
months to another authority other than the licensing authority to whom this
application is made stating:
i) name of the Local Authority
ii) date on which the licence was granted
iii) date and nature of the performance
7. Particulars of each application for a licence made during the last twelve months
and refused by any other Local Authority stating:
i) name of the Local Authority
ii) place of the performance
iii) nature of the performance
iv) name of the person responsible
8. Particulars of each performance during the past twelve months for which a
licence was not required stating:
i) date of the performance
ii) place of the performance
iii) nature of the performance
iv) name of the person responsible
9. Particulars of each performance during the past twelve months for which a
licence was not required stating:
i) nature of the employment
ii) days on which the child is employed
iii) times which the child is employed
10. Particulars relating to the sums earned by the child during the past twelve
months stating:
i) whether the sums earned were in respect of performances for which
a licence was granted, not required or other forms of employment
ii) amount of sums earned
iii)
iv)
date payment was received
name, address and description of the person from whom payment
was received
I support this application for a licence.
I certify that to the best of my knowledge, the foregoing particulars are correct and
I understand that if a licence is granted, it will be subject to the restriction and

conditions laid down in the Children (Performances) Regulations 1968, and to such
other conditions as the Local Authority may impose under the said regulations.
Name of Parent/Guardian:
Full address:
Postcode:
Tel No:
Relationship to child:
*State if parent, guardian or other person for the time being having charge or
control over the child
Signature:
Date:
Note: Any person who fails to observe any condition to which a licence is granted
or knowingly or recklessly makes any false statement in or in connection with an
application for a licence is liable to a fine not exceeding level 3 on the standard
scale (currently £1000) or imprisonment for a term not exceeding three months or
both (section 40 of the Children and Young Persons Act 1963)
INFORMATION SHARING AND PHOTGRAPHS – Data Protection Act.
The photographs supplied with the application will be used and stored for the sole
purpose of providing a licence to perform. This information will be stored securely
electronically and manually. (Photographs will be scanned and stored with
personal information electronically)
THE ORIGINAL PHOTOGRAPHS WILL NOT BE RETURNED TO YOU AND WILL BE
DESTROYED WHEN THEY ARE NO LONGER NEEDED FOR THE PURPOSE THE
IMAGES WERE PROVIDED FOR.
In order to use the images, Sefton Children’s Services require your consent for the
use and storage of this information. Young people aged 12 years and over should
consent for their images to be used. Parents/carers should also consent for the
use and storage of information and photographs of their children.
I consent for my images (Photographs) to be used as above:
Signed:____________________________________________________Young Person
I consent for my child’s images (Photographs) to be used as above:
Signed:_____________________________________________________Parent/carer