Personal Information Form - Support Person

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Thank you for completing this form.

As a regular support person attending an Upbeat Arts program, we ask that you take ten minutes to complete this form.
A friendly reminder that it is your responsibility to keep Upbeat Arts updated with any changes to the information provided here. All personal information collected by Upbeat Arts Ltd is confidential. You may access your own personal records at any time. 
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Name(Required)
Please use either your own personal email, or a personal work email - ie not a generic work email like admin@ or info@ etc.

If you've previously used this email address to register your client, please DO NOT complete this form - talk to us first.

Thank you.
Which program are you attending with them?(Required)
Tick any that apply

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Emergency Contact


It's important we know who to call in the event of an emergency. The emergency contact you provide below will be notified in case of emergency.

This contact can be the agency or organisation you work for.

Food Allergies


Gluten Free and Celiac
Dairy and Lactose Free
Nut Allergies
Seafood Allergies
None
Other

Media Statement


From time to time Upbeat Arts Ltd trading as Upbeat Arts may commission or require that photographs, videos, and/or audio clips of any Upbeat Arts programs and their members be created ("Materials").
Upbeat Arts requests the right and consent to use the Materials in relation to the provision of its ongoing community programs and activities. The Materials may also be used in relation to the reasonable promotion and publicity of Upbeat Arts programs and activities and its fundraising and sponsorship activities. Such use may include, for example, use of the Materials in brochures, posters, flyers, website, press releases and newspaper and television news and current affairs programs.
By signing this form, I agree with Upbeat Arts and otherwise consent as follows:
1. That Upbeat Arts may use the Materials in the manner set out above.
2. That Upbeat Arts may use my First Name in connection with the above use.
3. That there will be no financial compensation for any such use (including any royalty payments).
4. That Upbeat Arts may authorise others to use the Materials provided that their use shall be consistent with the terms of this release and consent.
5. I agree that the photographs/video and/or audio remain the physical property of Upbeat Arts. Any further use of the Materials (eg in relation to any book, publication or television program on a commercial basis) shall be subject to a further agreement between Upbeat Arts and myself.

Media Release(Required)
(1) However, I understand that by attending the program, I may be included in the background of photos/videos of group activities and performances. (2) We respect your rights completely, and we’ll speak to you individually to ensure you understand that when there are cameras around, we’ll ask you to step aside for a short time if needed. At public performances/engagements we cannot guarantee that your photo won’t be taken.

Our Behaviours


'Our Behaviours' are guidelines on how to behave as a member of Upbeat Arts team.

We encourage you to be familiar with these guidelines, both for your own interactions with us and to support your client.

By agreeing to the points within 'Our Behaviours', you agree to follow these guidelines and understand that we will speak with you if we feel you are not abiding by them. If required, we may issue a verbal or written warning, or in extreme situations, suspension or expulsion from your program may result.

* Respect and Kindness


We are respectful of each other’s rights and beliefs and always speak with kindness and an open heart.
We refrain from negative or hurtful comments. We are inclusive and accepting of everyone – knowing we are all equal.
If we have a concern about something to do with our program or another person, we’ll speak with the program leader directly.
We know that aggressive verbal or physical bct and kindness
ehaviour is not ok.

* Doing our best and having fun


We’ll attend our program regularly and know that as long as we do the best we can, that’s ok. If we can’t make our program, we’ll do our best to let Upbeat Arts know.
We’ll be clean and sober at all Upbeat Arts programs, performances and events.
Having fun is key. We’ll learn, meet new people and enjoy the journey we’re on.

* Inspire Others


Be a role model by demonstrating a positive attitude, resilience, dedication and a willingness to learn and grow.
Be a good listener by showing a genuine interest in others and hearing their thoughts, feelings and experiences.

Our Behaviours(Required)

THANK YOU - you did it!

We appreciate you taking the time to complete this information, which is a requirement for all members and regular visitors to our Upbeat Arts programs.

Now you're ready to hit the 'submit' button below.