Pointers Dance Studio & Gymnastics Academy
Registration Form
Pupil's Details
Name
*
First Name
Last Name
Date of Birth
*
-
Day
-
Month
Year
Date
Address
*
Street Address
Street Address Line 2
Town/City
County
Post Code
Parent / Guardian Contact Email
*
example@example.com
Parent / Guardian MOBILE Phone Number
*
Emergency Contact Details
Emergency Contact Name
*
Emergency Contact Phone Number
*
Relationship to child
*
Medical Information
Please provide any relevant medical details (e.g. Allergies)
Any other information we should be aware of
Terms & Conditions
Please read our
Terms & Conditions
I have read and agreed to the terms and conditions
*
I Agree to the terms and conditions
Parent / Guardian's Name
*
Signature
*
Submit
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