Application for Chaperone’s Licence

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Application to Devon County Council for the issue of a Chaperone's Licence

CHILDREN AND YOUNG PERSONS ACT 1963

CHILDREN (PERFORMANCE) REGULATIONS 1968

THE CHILDREN (PERFORMANCES) (MISCELLANEOUS AMENDMENTS) REGULATIONS 1998

All information given in this application form will be treated in confidence, other than information in relation to criminal offences.

Within this form you will be required to upload a recent photo image of yourself and identity documents - this will form part of the DBS process.

If you are currently signed up to the DBS update service, then all you will need to do is give us sight of your certificate and your ID number so that we can check this for you (please upload a scanned copy with your application form and photo).

Additionally, you will also be required to provide the names, addresses and email addresses of two referees who are able to comment on your suitability to act as chaperone (preferably from the society you will be chaperoning for and your current employer if you have one.

It is important before completing this form that you read the Fact Sheet for Chaperones.

If you have any queries please contact the Child Employment and Entertainment Officer on 01392 287223 or email educate.childemploymententertainment-mailbox@devon.gov.uk

Applicant Details: *

Title:	*
Surname:	*
First Name(s):	*
Previous Name(s):	*
Date of Birth:	*
Address:	*
Post Code:	*
Email Address:	*
Tel No(s):	*
Present Employer:	*
Type of Work:	*

For whom will you mainly be operating as a CHAPERONE? (Name of Company/Group etc.) *

Will you be paid or unpaid as a chaperone? *

Paid
Unpaid

Have you had any prior experience of supervising Children or young people? (Please note that answering No to this question does not necessary preclude you from becoming a Chaperone but it may be necessary for us to ask you some additional questions) *

Yes
No

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