Jamie-Lee Dance Company Registration Form

Jamie-Lee Dance Company Registration Form
Welcome to Jamie-Lee Dance Company online registration.

Please see the timetable below and select what classes you would like to trial. Once paid you will automatically booked in for the trial on your selected date.
Please select your trial week

This weekNext week

Classes

Monday Please select your classes

£4.00

Class	Quantity	Price
Streetdance		£4.00
Tumbling		£4.00

Tuesday Please select your classes

£4.00

Wednesday Please select your classes, musical theatre is a two hour classes and is more than other.

£8.00

Class	Quantity	Price
Musical Theatre		£8.00

Thursday Please select your classes

£4.00

Friday Please select your classes

£4.00

Total

£0.00

APPLICANT INFORMATION

Dancers Details
Full Name:*

First NameLast Name
Date of Birth:*

MonthDayYear
Age *
Returning Student *
Address:*

Address

Street Address Line 2

City Province

Postal Code
Primary Phone:*

Example: 07436576890
Medical Details
Medical Address *
Please list full address including postcode
Medical Phone *
Pre-existing Injuries
Leave Blank if None
Medical History - Allergies/Disabilities/Special Needs/Medications
Leave blank is none
PARENT/GUARDIAN

If you are registering as an adult dancer, it is not required for you to fill out the form below. Parents who register on behalf of their adult children, please fill out below. For minis, it is mandatory to have at least one parent/guardian contact.
Parent/Guardian 1:

First NameLast Name
Parent/Guardian 2

First NameLast Name
Primary Phone:

Phone Number
Alternative Phone:

Phone Number
E-mail:*
example@example.com
Comments or Questions

Sibling(s)
SIBLINGS

Do you have a sibling(s) or additional children that will be registering as well? If so please continue to fill in the details below, if not please leave blank.
Sibling 1
Name

First NameLast Name
Please select what class(es) you or your child are interested in.
Before selecting please bare in mind the age limit for each class.
Age & D.O.B
Medical Details - SAME AS ABOVE
Medical Address
Please list full address including postcode
Medical Phone
Medical history or Pre-existing Injuries
Leave Blank if None
Sibling 2
Name

First NameLast Name
Please select what class(es) you or your child are interested in.
Before selecting please bare in mind the age limit for each class.
Age & D.O.B
Medical Details - SAME AS ABOVE
Medical Address
Please list full address including postcode
Medical Phone
Medical history or Pre-existing Injuries
Leave Blank if None
Sibling 3
Name

First NameLast Name
Age & D.O.B
Please select what class(es) you or your child are interested in.
Before selecting please bare in mind the age limit for each class.
Medical Details - SAME AS ABOVE
Medical Address
Please list full address including postcode
Medical Phone
Medical history or Pre-existing Injuries
Leave Blank if None

APPLICANT INFORMATION