Staff Registration

Stomp 2024

Thank you for taking the time to register at Stomp 2024. We, and all participants, are very grateful. Without your help we could not put on this event.

Your Information

First Name

Last Name

Email Address

Membership Number If known, this can help speed up any checks we need to do.

Parental Consent

If the person named above is under 18 this form must be completed by parent/guardian.

18 or older

Under 18

Parent/Guardian's Name

Parent/Guardian's Email Address

Roles

Preferred Role

Additional Information

Anything else you think we might need to know - also let us know if you can help with build or takedown, what time you can arrive or need to leave.

Contact Information

Address Line 1

Address Line 2

Address Line 3

Post Code

Phone Number

Emergency Contact Information

Contact Name

Contact Phone Number

Alternative Contact Number

This information is stored and processed in compliance with our Data Protection policy.

Medical

Date of Birth

Day

Month

Year

Gender

Other

Dietary Requirements
Does the participant named above have dietary requirements?

Yes

Dietary Information

Vegetarian

Gluten Free

Lactose Free

Vegan

Egg Free

Nut Free

Medical Details
Does the person named above have any allergies, special needs, impairments, medication or noteworthy considerations that we should be aware of?

Yes

Medical Information

Form Security

Password

Password Confirmation

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