Registration Form

Student Registration Form

Fill out the form carefully for registration - Southampton Dance Academy (SDA)
Pupil Name

First Name Last Name
What does your child prefer to be called?

First Name Last Name
Date of Birth

Month Day Year
Date
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
1st Contact name
Email
example@example.com
1st Contact phone

Area Code Phone Number
2nd Contact name
Phone Number

Area Code Phone Number
Previous dance experience:
If your child has danced else where they may have the following numbers. ISTD Pin: ULR:
This ONLINE form mirrors our paper registration system.

We confirm that you have read our handbook available online, by email or in a paper copy and understand the policies and principles by which we operate.

By signing this form you are agreeing to the above statements and that SDA will store the details you share on our software system.

Data Protection

SDA stores email and phone number for parents and personal details of students digitally on a secure database. We delete these files as required and will never pass on your details.
Medical conditions and allergiesDo you/your child have any conditions which would make it unsafe to participate in dance classes?

YES NO
If yes please detail:
Do you/your child have any allergies that require emergency medications?

YES NO
If yes please detail:
Do you/you rchild require additional support to attend classes? YES/NO

YES NO
If Yes please detail:
Ballet and Pilates are taught using methods involving some ‘hands on correction’. Do you understand and AGREE to this method of teaching?

YES NO
SDA hold exam sessions through out the year for students who have reached the standard required. Please let me know if you would prefer to opt out of the exam system.

My child would like to take exams My child would not like to take exams
SDA hold school performances which all children are invited to participate in. *Do you give permission for your child to take part in school productions?

YES NO
SDA will video school productions for parents to have copies, and take photographs for publicity purposes (ie images on the school website etc). Do you agree for your child to be involved in this?

YES NO
All students must be dropped to and from venues UNLESS I have parental permissions for them to leave unaccompanied. For students aged 11 plus please give permission

I give permission for my child to leave unaccompanied I do not give permission
Signature

Clear
Date of signature

Month Day Year
Date
Should be Empty:

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Student Registration Form