BRIGHT MOVEMENT WORKSHOPS 2025
Saturday 6th September . Southwards museum Kapiti. Contact: belindabingzs@gmail.com
Email
*
example@example.com
Dancers Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Date of Birth
*
-
Day
-
Month
Year
Date
Dancers Age at 16th September
*
4
5
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8
9
10
11
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Dance School
*
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U12 Years
1. Lyrical - U12 years 1pm with Jeannie Whyman
$25
2. Jazz - U12 years 2pm With Emma Maddock
$25
3. Contemporary - U12 years 3pm with Amelia Butcher
$25
4. Hip Hop - U12 years 4pm with Birdy
$25
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12+ Years
11. Jazz - 12+ years 1pm with Emma Maddock
$25
12. Lyrical - 12+ years 2pm with Jeannie Whyman
$25
13. Hip Hop - 12+ years 3pm with Birdy
$25
14. Contemporary - 12+ years 4pm with Amelia Butcher
$25
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I confirm that by completing and submitting this form that we/I agree to Photos and videos of my child being used for media
*
I agree
Full payment is due within 48 hours of submitting form to confirm your spot. Account Details are as follows B Warrington 15-3959-0640191-26 ref childs first and last name.
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