Busby Dance Registration
Fill the registration form below.
Student's Name
First Name
Last Name
Parent's Name
First Name
Last Name
E-mail
Phone Number
-
Area Code
Phone Number
Gender
Male
Female
Date of Birth
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Address
Street Address
Street Address Line 2
City
County
Postcode
Type of Dance
Baby Ballet
Beginner Ballet
Street Jazz Abingdon
Street Jazz Dorchester
Nettlebed Lunchtime club
Party Attendee
Ashbury Dance Club
Ducklington Afterschool Club
Are there any health issues, allergies and any other conditions we should be aware of?
I agree to allowing my child to participate in Busby Dance classes. By letting your child participate in Busby Dance classes you are agreeing that you understand there is risk in participating in any form of exercise. I am waiving any claim made against Ellen Busby and Busby Dance in liability of any case of accident or injury.
Yes
No
I give permission for Ellen Busby and other teachers of Busby Dance to record videos and photos which can be used to promote Busby Dance on promotional material, Busby Dance website and social media). By agreeing you understand that these will belong to Busby Dance. I waive any claim to the property of the materials.
Yes
No
Covid-19: I agree that I will adhere to any precautions outlined by Busby Dance to reduce the spread of Covid-19. I confirm my child will not attend Busby Dance classes if my child or any family member exhibits any symptoms of Covid-19. I confirm that we will not return to classes until we have served the isolation period:
Yes
No
How did you find out about Busby Dance?
Google
Social Media
School
Word of mouth
Other
Submit
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