Children(NorthernIreland)Order1995

Children(PublicPerformances)Regulations(NorthernIreland)1996

APPLICATIONFORALICENCE
ApplicationtotheSouthEasternEducation&LibraryBoard PARTI(TobecompletedbytheApplicant) 1 IherebyapplyforalicenceunderArticle137(1)(a)oftheChildren (NorthernIreland)Order1995authorisingthechild:

*(1) *(2)

totakepartinperformancesonthedatesspecifiedinitem4(i)oftheannexe. to take part in performances on the number of days and during the period specifiedinitem4(ii)oftheannexe.

*Deleteifinapplicable 2 3 (i) (ii) I certify that to the best of my knowledge the particulars contained in the annexearecorrect. Iattachthefollowing: thebirthcertificateofthechildorothersatisfactoryevidenceofthechildsage; twoidenticalprints(unmounted)ofaphotographofthechildtakenduringthe sixmonthsprecedingthedateofthisapplication;nameprintedanddatedon theback. acopyofthecontract,draftcontractorotherdocumentscontainingparticulars of the agreement regulating the childs appearance in the performances for whichthelicenceisrequested;and adeclarationunderArticle138(4)(a)oftheChildren(NorthernIreland)Order 1995.

(iii)

(iv)

*Deleteifinapplicable

Iunderstandthatifalicenceisgrantedtomeitwillbegrantedsubjecttothe restrictions and conditions laid down in the Children (Public Performances) Regulations(NorthernIreland)1996. Date:_________________ Signed:____________________________ (Applicant)

Full

ANNEMCCLEARY

Name: Address:

5LAGANVALECOURT,BELFAST CIVILSERVANT

Occupatio n:

Telephone 07803132499 Number: Email address anne.mccleary@ntlworld.com

AnnexetoPartI ParticularsconnectedwiththePerformanceinwhichthechildistotake part.

1 Name and nature (a) of the LesMiserables,SchoolsEdition performance in respect of which the Theatricalperformance licenceisrequested. Descriptionofchildspart. Chorusmember

2 3

Placeoftheperformancesinrespectof IslandHall,LaganValleyIsland whichthelicenceisrequested(b). (i) The dates of performances for which 69Feb2013 thelicenceisrequested;or

(ii)

the number of days, and the period 4evenings. duringwhichitisrequestedthatthe childmaytakepartin performances (c). Timeanddurationofperformancesin 7.30pmto10pm respect of which the licence is requested. Approximate duration of the childs 1hourapprox appearances in the performances in respect of which the licence is requested. Theamountofnightwork(ifany)for None which approval will be sought from the board in whose area the performance takes place under regulations32oftheChildren(Public Performances) Regulations (Northern Ireland)1996stating: theapproximatenumberofdays; The approximate duration on each day. Thesumstobeearnedbythechildin None taking part in the performances in respect of which the licence is requested.

(i) (ii) 8

(a) (b) (c)

Natureofperformances,egtheatrical,filming,televisionetc. Thisincludestheplacesatwhichworkonlocationistobedone. Alicencespecifyingthenumberofdaysonwhichachildmayperformandthe period,notexceedingsixmonths,inwhichtheperformancemaytakeplacemay begrantedonlyto:

theBritishBroadcastingCorporation;or

(i)

(ii) thoselicensedbytheIndependentTelevisionCommissionorRadioAuthority;or (iii) personsproducingprogrammesforthosementionedunder(i)or(ii);or (iv) personsrecordingperformances(bywhatevermeans)withaviewtoitsuseinafilmintendedfor publicexhibition.

Proposedarrangementsforrehearsals takingplaceduringthefourteendays preceding the first performance for whichthelicenceisrequested,stating inrespectofeachrehearsal:

Mon4thandTues5thFeb710pm Sun3th25pm Sat2nd5pm. Mon28andWed30Jan6.30 10pm Sat26thJan36pm Wed22ndJan710pm Asabove All above rehearsals prior to Sunday 3 Feb in Lisburn EnterprisePark,Unit506 Rehearsals post 3 Feb in Island Hall,Lisburn

(i) (ii)

thedate; theplace;and

(iii) 10

theapproximateduration.

Timingsabove

Thedaysorhalfdaysonwhichleave None ofabsencefromschoolisrequestedto enable the child to take part in performancesforwhichthelicenceis requestedorinrehearsals. Proposed arrangements (if any) under regulation 12 of the Children (Public Performances) Regulations (Northern Ireland) 1996fortheeducationofthechild during the period for which the licenceisrequestedstating: thenameandaddressoftheschool tobeattended. the name, current address, other None

11

(i)

n/a

(ii)(a)

n/a

addresses in the previous five years,teacherreferencenumber(if any) and qualifications of the proposedprivateteacher; (b) the place where the child will be taught; theproposedcourseofstudy; the number of other children to taught by the private teacher at the same time as the child in respectofwhomthisapplicationis made,andthesexandageofeach suchchild; whetherthechildistoreceivethe required amount of education in accordance with regulation 12 (4) (a)orregulation12(4)(b). n/a

(c) (d)

n/a n/a

(e)

n/a

12

Thenameoftheboard(ifany)which n/a has previously approved the appointmentoftheprivateteacherfor thepurposeofalicence. The name, current address, other addresses in the previous years and qualificationsoftheproposedmatron inaccordancewithRegulation14. Thenameoftheboard(ifany)which BelfastEducationBoard had previously approved the appointment of the matron for the purposesofalicence. Thenumberofotherchildrentobein chargeofthematronduringthetime when she would be in charge of the child in respect of whom this applicationismade,andthesexand

13

14

15

ageofeachsuchchild. 16 Theaddressofthelodgingwherethe n/a childwillliveifalicenceisgrantedby reasonofwhichthechildhastolive elsewherethanattheplacewherehe wouldotherwiselive,thenameofthe householderandthenumberofother children who will live in the same lodgings. Approximatelengthoftimewhichthe childwillspendtravelling: to the place of performance or Lisburn30mins rehearsal; From the place of performance or Isburn30mins rehearsal; And the arrangements (if any) for transport; Nameofanyotherlicensingauthority SouthernBoard to which an application has been madeforanotherchildtotakepartin performancestowhich this applicationrelates.

17

(i)

(ii)

18

TheChildren(Performances)Regulations(NorthernIreland)1971 APPLICATIONFORALICENCE PARTII (TobecompletedbyaParent)

Pleasegivethefollowingparticulars: 1 2 3 Fullnameofchild Date of birth of child Addressofchild

Nameandaddressesofschoolsattendedbythe child duringthetwelvemonthsprecedingthe date of this applicationor,ifhehasnotattended school, the name andaddressofhisprivate teacher. Particulars of each licence granted during the twelve months preceding the date of this applicationbyanyboardotherthanthelicensing authority to whom this application is made, statingineachcase: thenameoftheboard; thedateonwhichthelicencewasgranted; thedatesandnatureoftheperformances. Particulars of each application for a licence made during the twelve months precedingthedateofthisapplicationandrefusedbyanyboardotherthanthe licencingauthoritytowhomthisapplicationismade,statingineachcase: thenameoftheboard; none

(i) (ii) (iii ) 6

(i)

(ii) (iii ) 7

thedateoftheapplication; thereasons(ifknown)fortherefusaltograntalicence. Particularsofeachperformanceforwhichalicencewasnotrequiredinwhichthe childtookpartduringthetwelvemonthsprecedingthedateofthisapplication, statingineachcase: thedate; theplace; thenatureoftheperformance; thenatureofthepersonresponsiblefor the production of the performance in whichthechildtookpart. Dates (if any) on which the child has None been absent from school during the twelvemonthsprecedingthedateofthis applicationbyreasonofhistakingpart inaperformance. Particulars of any other form of None employment in which the child is employed during the twentyeight days preceding the day of the first performance for which the licence is requestedstating: thenatureofemployment; thedaysonwhichthechildisemployed; the times during which the child is employed. Particularsrelatingtothesumsearnedbythechildduringthetwelvemonths none

(i) (ii) (iii ) (iv )

(i) (ii) (iii ) 10

precedingthedateofthisapplicationstating: (i) whetherthesumsearnedwereinrespect None ofperformancesforwhichalicencewas granted, performances for which a licencewasnotrequiredorotherformsof employment; theamountofthesumsearned; thedateonwhichpaymentwasreceived; thename,addressanddescriptionofthe person from whom the payment was received.

(ii) (iii ) (iv )

Isupportthisapplicationforalicence. IcertifythattothebestofmyknowledgetheforegoingparticularsarecorrectandI understandthatifalicenceisgranteditwillbegrantedsubjecttotherestrictionsand conditions laid down in or under the Children (Public Performances) Regulations (NorthernIreland)1996. Date : Signe d: (Parent) Fullname: Address: *RelationshiptoChild TelephoneNumber:

Statewhetherparentorpersonwithparentalresponsibilityorperson havingcareof,orcontrolover,thechild.