ACT Application | ACASS Children's Theatre

Section A: Learner and Guardian Details

Basic learner information and parent or guardian contact details.

Full name

Surname

Gender

Date of birth

Age

Learner email

Learner phone number

Home address

Parent/guardian full name

Parent/guardian surname

Parent/guardian contact number

Parent/guardian email address

Section B: Programme Selection

Select the ACT programme stream, grade group, transport, fees, medical, and emergency information.

Section C: Activity and Media Use

Choose the purposes for which learner images, audio, or video may be used.

Marketing and promotional materials Social media platforms Website and digital platforms Educational or training purposes Reports, presentations, or newsletters

Section D: Consent

Parent or guardian media consent for learner participation.

I give consent I do not give consent

Consent applies to images, audio, and video recordings for the selected purposes above.

Section E: Data Privacy

POPIA compliance acknowledgement.

I understand that my child's images, audio, and video recordings are considered personal information and will be processed lawfully and responsibly in line with South African data protection laws. I understand that I may withdraw consent in writing at any time.

Section F: Declaration and Sign-off

Parent or legal guardian declaration before submission.

I confirm that I am the parent or legal guardian of the learner named above, and that all information provided is true, accurate, and complete. I undertake to maintain effective and responsible communication with ACASS representatives and the school supporting the programme. I acknowledge that ACASS representatives will exercise professional care and support during learning environments, workshops, events, excursions, and activities. I understand and accept responsibility for safe transport arrangements unless otherwise agreed in writing. I acknowledge that I have read, understood, and accepted the terms and responsibilities outlined for participation in the ACT programme.

Full name digital signature

Date of consent

Upload signature image or document

Secure consent file upload will be enabled after the private ACT file workflow is connected. Your typed digital signature and consent date are submitted now.