Chaperone Application Form

Please note that the London Borough of Hillingdon, as the Licensing Authority, may refuse to grant a licence if the application form is not received by us at least twenty-one days before the day on which the first performance for which the licence is required takes place. This is in accordance with Part 1, Regulation 1 of Children (Performances) Regulations 1968.

By making this application underneath, you consent to London Borough of Hillingdon, the Licensing Authority, processing your personal information for the purposes of assessing whether a licence should be approved for a chaperone. The London Borough of Hillingdon has a legal obligation to only approve a Chaperone where we are satisfied that the applicant is suitable and competent to exercise proper care and control of a child, under Regulation 12(2) of Children (Performances) Regulations 1968.

London Borough of Hillingdon will make such enquiries as we consider necessary to enable us to be satisfied that we should grant a licence. This includes carrying out checks with agencies such as the Police, DBS, Social Care at London Borough of Hillingdon and at other Local Authorities, NHS/Health services and any other relevant agencies to ensure the safety of our residents and child performers. The London Borough of Hillingdon can do so by law, under Part 1, Regulation 2 of Children (Performances) Regulations 1968.

By signing the Declaration, you consent to the London Borough of Hillingdon carrying out enquiries and checks with Children Social Care at London Borough of Hillingdon on an annual basis for the duration of the licence. This may also involve notifying agencies and other organisations that we deem relevant, that a licence is subsequently revoked.

Please complete this form in type or block capitals. An incomplete application form will result in the form being returned to the applicant and delay the application process.

For further information please contact the Applications Admin Team via email at applicationsadmin@hillingdon.gov.uk

For further information on how we process your personal data, please refer to the Council’s privacy notice at https://www.hillingdon.gov.uk/