SATURDAY BALLET

1

Student Name* This field is required.

First Name

Last Name

2

Which date(s) would you like to book?* This field is required.Students who book all 5 classes pay only £37.50 for the block. Single classes are available at £9.00 per class. ***Please note there is no Ballet on 22nd Nov or 6th Dec***

1st Nov

8th Nov

15th Nov

29th Nov

13th Dec

3

Payment Details* This field is required.To secure your place, transfer payment to EAST SUSSEX DANCE LIMITED - *New Bank Account* Sort code 08 92 50 Acc 63333510 (Co-Operative Bank)

Date of Transfer

Amount Transferred

Payment Reference

4

Email* This field is required.

example@example.com

5

Contact Phone Number* This field is required.

Country Code (+44)

Phone Number

6

Any injuries or medical conditions we should be aware of?Please note that although teachers can advise adaptations, participation is at your own risk.