Creative Dance for Children Registration Form

Registration Form - Creative Dance For Children

Fill out the form carefully for registration
Class you child will attend (your child can only attend class appropriate for his/her age)
Child's Full Name
Type your child 1st name followed by middle name followed by surname
Child's Name

First NameLast Name
Parent's Name

First NameLast Name
Parent's E-mail

Confirmation Emailexample@example.com
Parent's Mobile Number
PLEASE DO NOT TYPE COUNTRY CODE IF YOU HAVE UK NUMBER !Format: 0000 000 0000.
Child's Birth Date

DayMonthYear
Child's Age
Age Category (Westminster Council Categories)
Child's Gender
Child's Address

Street Address

Ward

CityBorough

Post Code
Ethnicity Categories (please note these are Westminster Council categories)
Religion Categories (please note these are Westminster Council categories)
Child's Ethnicity
Do you consider your child yo have disability or learning difficulty?
If Yes, please elaborate If No, type N/A
Does your child have any health issues teachers should know about?
If you child has attended our classes before, what class did she/he attend?
How would you rate the classes your child has attend with us in the past?
Where did you hear about us?
Choose one

Other
Additional Comments
I give permission for photos or videos to be taken of my child during the classes/performances & to be used by Mala CHERGA Theatre and funders for publicity and website.

I knowingly, voluntarily and expressly waive any claim I may have against Mala CHERGA Theatre for injury or damages that my child may sustain as a result of participating in classes or workshops.
Signature
IMPORTANT

When you submit your registration form you will receive an email from 'Jotform' with your registration form and a word document in the attachment entitled 'IMPORTANT INFORMATION AND ZOOM LINKS'. Please read this document carefully and save the zoom links for online classes.

We look forward to seeing you,

Mala CHERGA team
Mala CHERGA Theatre classes are funded by Westminster Council's Community Priorities Programme
Should be Empty:

Registration Form - Creative Dance For Children

Mala CHERGA Theatre classes are funded by Westminster Council's Community Priorities Programme