Contact Form:
Please ensure you fill out this contact form before attending any of our classes so we have all your contact details in case of an emergency.
Dancers Name
*
First Name
Last Name
Dancers D.O.B (dd.mm.yyyy)
Parent/Guardian Name
First Name
Last Name
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
E-mail Address - this is how we will correspond with you as we are a paperless dance school
example@example.com
I give permission to take photographs and/or videos of my child. I grant full rights to use the images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve the group's aim
Please Tick
Are you taking any medication? (If yes, please state below)
Do you have any injuries that will affect your ability to dance? (If yes, please state below)
Is there anything else you need us to know
*
Submit
Should be Empty: