Paragraph 3
Details of each licence in relation to the child granted during the twelve months preceding the date of the application by any local authority or, in Scotland, any education authority, other than the licensing authority to which the application is made, stating in each case—
(a)
the name of the local authority or the education authority;
(b)
the date on which the licence was granted; and
(c)
the dates and nature of performances or activities.