Application For Children's Entertainment Licence

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