Chaperones in Entertainment
Application Procedure Guidance
Once we have received your application to be approved as a Chaperone in Entertainment, a
role which will bring you into close contact with children, we must make every effort to check
on the suitability, character, and criminal background of all applicants. You will appreciate
therefore the need to complete the enclosed forms.
The enclosed paperwork should include all the following: -
Application Form for Approval as a Chaperone
Children’s Services Identity Check (Personal Details form)
Social Services Check
To be completed and returned to the office of the Licensing Officer with original supporting
documents.
Chaperone / Tutor Application Form
If you have any queries about this form, please contact the Child Employment Officer on
0161 603 4350
Social Service Personal Details Form
Please complete section 2 to enable your details to be checked by Social Services.
Please call the Licensing Officer on 0161 603 4350 to arrange to visit our offices at
Safeguarding Children and Quality Assurance Unit, Child Employment, Sutherland
House, 303 Chorley Road, M27 6AY in order for the form to be completed and for you to
bring with you the original supporting documentation needed to verify your identity and
payment for the processing of your DBS application.
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The documents you need to provide are as follows:
1 document from the following group:
 Current valid passport
 UK issued driving license (both parts – photo card and paper license)
 Birth Certificate (the original one issued at the time of your birth)
PLUS
2 documents from the following group, (1 of which must verify current address):
 Current UK driving license (old paper license)
 Birth Certificate (issued after time of birth by Registrars)
 Marriage/Civil Partnership Certificate
 Adoption Certificate
 Mortgage Statement (original/not photocopy or printout – issued in last 12
months)
 Bank/Building Society Statement (original/not photocopy or printout – issued
in last 3 months)
 Credit Card Statement (original/not photocopy or printout – issued in last 3
months)
 P45/P60 Statement (original/not photocopy or printout – issued in last 12
months)
 Council Tax Statement (original/not photocopy or printout – issued in last 12
months)
 Utility Bill – not mobile telephone (original/not photocopy or printout – issued
in last 3 months)
If you have a problem providing any of the documents listed please contact the Licensing
Officer for further advice.
Photographs
Two recent identical passport type photographs are required with your application.
Payment for Professional Chaperones
The Standard charge for a DBS application is £44.00. This is paid to the Disclosure & Barring
Service. An Additional administration fee of £20.00 will be charged by Salford City Council for
processing this application. The cheque for a total of £64 must be made payable to Salford City
Council.
Payment for Volunteer Chaperones
The standard charge for a Volunteer Chaperone will be an administration fee for £20.00 only.
A cheque of a postal order should be made payable to Salford City Council
N.B this license will not entitle you to undertake any paid or professional chaperone assignments.
Interview
The process of writing to references and completing the checks takes 6 - 12 weeks
(due to the time taken for the DBS check to be returned). When these have been
completed satisfactorily you will be asked to complete on line safeguarding training
and when completed invited in for an informal interview, following which you should
be issued with your authorisation.
If you have any questions please do not hesitate to call
The Licensing Officer on 0161 603 4350
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The Children (Performances and Activities) (England) Regulations2014
Application for approval as a Chaperone
"The Licensing Authority shall not approve a Chaperone unless they are satisfied
that she (he) is suitable and competent to exercise proper care and control of a child
of the age and sex of the child in question; (Regulation 15(4a), The Children
(Performances and Activities) (England) Regulations 2014.
All information given in this application form will be treated in confidence, other than
information relating to criminal offences. Please complete this form in type or block
capitals.
Please complete all sections
Surname (Block letters)
Mr/Mrs/Ms/Miss/Other*
First Names (Block letters)
Date of Birth
Place of Birth
Address (inc. postcode)
Telephone Number
Mobile Number
Email Address
How long have you lived at
this address?
If less than 5 years please
list previous address(es)
National Insurance
Number
What is this application for?
(please tick all applicable)
Have you been employed
previously as a chaperone in
either this Local Authority or
others?
Have you been approved as a
registered child minder or foster
carer?
Chaperone
Professional
Volunteer
Tutor
Yes
No
Which Local Authority?
Yes
No
Give details:
What experience do you have of working with children and young people?
Please include all voluntary and professional experience
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If you drive a car does your car insurance allow you to carry
passengers whilst employed as a chaperone? (You may need to check
with your insurer)
Are you registered disabled?
Yes
No
Yes
No
Do you have a health condition which may affect your application?
Please Specify below
Yes
No
References
Please give details of two referees – neither of these should be a member of your family or your partner
and one of them must be able to indicate your suitability to look after children
Name
Name
Address
Address
Postcode
Postcode
Telephone
Telephone
Occupation
Occupation
Tutors are sometimes employed by production companies to assist children with their education whilst in
theatres, on film sets, or in recording studios. These tutors must be suitably qualified and approved by the
child’s Local Education Authority.
Do you wish to apply
Yes
No
for approval as a tutor?
DfES Number
Teaching Qualifications
(copies are required)
Current teaching post OR if unemployed, your last teaching post including dates (Please supply
the name and address of a referee for this post as reference will be made to this person)
Post held
Dates from & to
Name & Address of
referee
Postcode
Page 4 of 11
Telephone number
The Rehabilitation of Offenders Act
The Rehabilitation of Offenders Act allows for a person who has been convicted of a criminal offence
involving a sentence of not more than 2.5 years imprisonment and who has since lived trouble free for a
specified period of time (related to the severity of the offence) to be treated as if the offence, conviction or
sentence had never occurred. This is known as a spent conviction.
The position for which you are applying is one of those to which the provisions of the above Act in relation
to spent convictions, do not apply. You must therefore disclose whether you have any previous
convictions, whether or not they are spent. Should you disclose a criminal conviction, this will be
discussed with you in confidence. However you should note that only convictions that are relevant to the
position in question will be taken into account.
Do you have any criminal convictions (whether spent or
unspent), cautions, reprimands, final warnings, or prosecutions
pending?
Yes
No
If Yes, please give details
If you do not disclose any convictions you have it could lead to your application being rejected, or, if you
are approved, may lead later to your authority being withdrawn. People who have convictions will be
treated fairly and given every opportunity to establish their suitability for the position; all applicants will be
considered on merit and ability.
Any information that you give will be kept in strict confidence and will be used only in respect of your
application for the position as Chaperone / Tutor.
Disclosure & Barring Service (DBS) Previously known as CRB
Applicants will be asked to apply for a DBS check from the Disclosure and Barring Service. A DBS Form
must be completed by the applicant in the presence of the Licensing Officer who will submit the form on
your behalf. A copy of the DBS Code of Practice is available on request. Further information about the
DBS scheme can be found at https://www.gov.uk/disclosure-barring-service-check
Declaration
I certify that the information I have provided is true to the best of my knowledge. I understand that if I give
false information or withhold relevant information it could result in my application being rejected or my
chaperone licence being withdrawn, if approved.
Signed::
Date:
If my application for approval is as a chaperone/tutor is successful I agree to notify Salford Council
Safeguarding Children Team within seven days of:
 Any arrest for any offence, or conviction for any offence (excluding fixed penalty fines) in a Court of
Law whether in the UK or elsewhere
 Any notifiable illness
 Any health condition or debility, which may affect my ability to carry out the duties of a chaperone
 Any or name or address
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If your application is approved, you will be issued with a certificate of approval and an identity
card. Your personal details (name and address etc.) will be added to Salford City Council
chaperone database, which is maintained and held by the Safeguarding Children Team. These
details are not shared with anyone outside the Safeguarding Children Team in the various Local
Authorities throughout the country.
When your application has been approved you may, if you wish, approach any organisation
(theatre, film/TV company, model/casting agents, etc.), who require approved chaperones, give
them your personal details and offer your services. These organisations may then contact Salford
Council to verify that you are approved. We will confirm only the fact that you are an approved
chaperone or tutor and the expiry date of your approval. No other personal details will be given to
these people or organisations.
However, Salford Council’s Safeguarding Children Team department occasionally receives requests
from theatres, film/TV companies or model/casting agents to supply them with the names and home
contact details of Salford’s approved chaperones. This is in order that they can then contact the
chaperones to offer short-term employment looking after or teaching children in studios, theatres or on
film sets. In anticipation of these requests a separate list is held of all the chaperones who have given
their consent to release their contact details to these people and organisations. This list is then sent to
theatres, film/TV companies or model/casting agents at their request. These people or organisations
may then contact one or many of the chaperones on this list offering employment, usually short
term/casual. Any chaperone contacted in this way is free to negotiate the terms of employment or to
decide whether or not to take up the offer on this occasion. These are matters for the chaperone and
the ‘employer’ and will not involve Salford Council.
Should your application be successful do you want your personal details (name, address and telephone
number, etc.) to be entered on this separate list and released to theatres and production companies?
(Please sign the relevant section below)
Your decision on this matter does not in any way affect whether your application is approved or not and
may be changed at any time in the future by notifying this office in writing.
YES, I do want my name entered on the list and released to other organisations
Signed: __________________________________________________
NO, I do not want my name entered on the list and released to other organisations
Signed: _________________________________________________
Page 6 of 11
SOCIAL SERVICES CHECK
Section 1
To the Applicant/Appointee
Current Department of Health Guidelines recommends that Salford Council check with Social
Care on the background of certain persons who will have access to children.
Please complete Section 2 to enable this check to be done.
Post: Chaperone for children in Entertainment
Section 2
Block Capitals Please
For completion by Applicant/Appointee to post in Section 1
First Names:
Surname:
Date of Birth:
Place of Birth:
Previous or other names (e.g. maiden name)
Present Address:
Post Code:
Length of time at this address:
From (date):
Telephone Number:
Mobile Number:
Please give previous addresses, in full, used within the last 5 years (state full postal address inc. post
code)
1.
Date from:
Date to:
2.
Date from:
Date to:
3.
Date from:
Date to:
Continue overleaf if necessary
We require details of your immediate family (Partner & Children) to undertake checks on their
involvement with Children’s Services Continue overleaf if necessary
Full Name
Date of
Birth
Address if different from yours
Any Criminal convictions,
please specify
In connection with the application specified in Section 1, I will have substantial access to
children and agree to enquiries being made in confidence from Social Care. (This information is
being used for the above purpose only).
Signed:
Date:
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Section 3
To Social Care
Can you please check the above person in CareFirst system, enter your findings in the space below
and return this form to the Child Employment & Licensing Officer, Safeguarding Children and Quality
Assurance Unit, Child Employment, Sutherland House, 303 Chorley Road, M27 6AY or email form to
childemployment@salford.gov.uk
Signed:
Date:
On behalf of Social Care
Page 8 of 11
IDENTITY CHECK FORM
Salford Approved Chaperone Licence
Post applied for:
Title Mr/Mrs/Miss/Ms/Other………
Forename:
Surname:
Address:
D.O.B:
_____/_____/_________
At present address since
Date:
_____/_____/__________
Postcode:
Contact tel no:
National Insurance Number:
E-mail Address:
Confirming your identity. To enable us to confirm your identity you must
provide documentation as listed below to be checked. This information must
be original - photocopies will not be accepted.
The documentation you need to provide
Can you produce any documents from Group 1 (see list below)
Please note documents from Group 1 are preferable
YES
NO
Three Documents must be seen:
Five Documents must be seen:
One document from Group 1 plus any two from
Groups 1 and 2
All from Group 2
Please tick in the box which document from Group 1 you are providing a copy
of:
Tick
Group 1
Passport – Any Nationality
UK Birth Certificate – Issued within 12 months of date of birth.
Non UK is Group 2.
UK issued Driving Licence – Counterpart AND Photo Card.
OR Old Style Paper Licence
EU National Identity Card -photograph & full name of holder
present
HM Forces ID Card
UK Firearms Licence
Adoption Certificate (UK)
Continued…….
Page 9 of 11
Salford CC
Group 2
- (Photocopies will not be accepted)
Date on
Document where
appropriate
Salford CC
Tick which checked
A document from UK Central/Local Government
Agency/Local Authority giving entitlement
e.g. Benefits Agency, Employment Service or Inland
Revenue (Must be less than 3 months old)
Addressed Payslip (Must be less than 3 months old)
Asylum Registration Card
Bank/Building Society Statement (Must be less than 3
months old)
Benefit Book e.g. Child Allowance or Pension
Certificate of British Nationality
Connexions Card
Council Tax Statement (Issued within last 12 months)
Court Claim Form - Documentation issued by Court
Services
(Issued within last 12 months)
CRB Disclosure Certificate (Issued within last 12 months)
Credit Card Statement (Must be less than 3 months old)
Exam Certificate e.g. GCSE or NVQ…etc.
Financial Statement (Issued within last 12 months)
Insurance Certificate (Issued within last 12 months)
Letter from Headteacher (Must be less than 3 months
old)
Mail Order Catalogue Statement (Must be less than 3 months
old)
Marriage / Civil Partnership Certificate
Mortgage Statement (Issued within last 12 months)
National Insurance Card
Non-Original Birth Certificate, issued after 12 months from
date of birth or non UK
UK P45/P60 (Issued within last 12 months)
Store Card Statement (Must be less than 3 months old)
UK NHS Card
Utility Bill, e.g. Electricity, Gas, Water, Telephone – home
or mobile (Must be less than 3 months old)
Valid TV Licence (Must be less than 12 months old)
Vehicle Registration Document (V5 old style or V5C new
style only)
Work Permit/Visa (Issued within last 12 months)
Issue Date:
Issue Date:
Nationality:
Applicant
Please sign below to confirm that you have supplied the documents
detailed within this form.
Signature: ___________________________________________
Date:_____/_____/________
Incomplete or incorrect documentation will cause a delay
in the DBS process.
Page 10 of 11
SALFORD CC USE ONLY –
Please verify documents in Group 1 have been provided by ticking in the column
above then complete information below where possible from documents provided.
Passport No;
Date of Birth;
Nationality;
Issue date;
UK Birth Certificate Issue date;
Country of Issue if Other;
Date of Issue;
Date of Birth;
Driving Licence No;
Date of Birth ;
Driving Licence Issue Date: ____/_____/____
Driving Licence Type: Paper / Photo Card
Country of issue: UK or Other (if other please state)
Salford CC use only
Please sign below to confirm that the required documents have been verified.
Has the applicant’s current address been verified?
YES / NO
Print name: ____________________________________
Sign: _________________________Date: ___/___/____
Position: ______________________________________
Contact number: ________________________________
.
If you would like any further information, or wish to make arrangements to
submit these application please contact the Child Employment Licensing
Officer – email childemployment@salford.gov.uk
or contact the; Safe Guarding Children and Quality Assurance Unit, Child
Employment, Sutherland House, 303 Chorley Road, M27 6AY.
Page 11 of 11