Gender

Male

Female

Gender diverse

T-shirt size *

(when we can, we buy everyone a "show" t-shirt so as to remember the occasion)

Youth - Small

Youth - Medium

Youth - Large

Youth - X-Large

Adult - Small

Adult - Medium

Adult - Large

Adult - X-Large

Other

Ethnicity *

(Select as many as you wish)

Māori

Pākehā

Pacific Peoples

European

Asian

Middle Eastern / Latin American / African

Other

Disability

(Select as many as you wish)

Cerebral palsy (CP)

Learning disabled

Autism/NeuroDiverse

Deaf or hard of hearing

Blind or vision impaired

Physical disability

Mental ill-health

Vulnerable - youth

Vulnerable – older

Isolated

Poverty

Other

Photos *

We sometimes take photos and videos of the participants in our classes for our social media, our website and for the short films we make. We rarely state the names of the person in the photo but if we do we only use their first name. Please tick to say whether you consent for us to take and then publish photo and videos of the participant.

Yes I give permission to Glass Ceiling to publish photos and videos of the participant.

No I do not give permission to use photos or videos of the participant.

Safety and Behaviour Agreement *

Safety for all participants, tutors and support people is our priority. Glass Ceiling Arts Collective reserves the right to remove participants from the programme immediately if they behave in a way that is deemed unsafe. This includes instances of bullying, violent behaviours, destruction of Glass Ceiling property, participant property, or venue property, inappropriate behaviours of any kind including sexually inappropriate behaviours. Threatening behaviours of any kind including from a parent and/or caregiver. Please tick to say you understand and agree with this statement.

I understand and agree with this statement