REGISTRATION FORM
Together We Dance
TUESDAY CLASSES
Mini Movers (3.5-6yrs) @ 4-5pm
Junior Contemporary Dance (7-9yrs) @ 5-6pm
Senior Contemporary Dance (10-16yrs) @ 6-7pm
WEDNESDAY CLASSES
Mini Movers (3.5-6yrs) @ 4-5pm
Senior AcroDance (9-16yrs) @ 5-6pm
THURSDAY CLASSES
Junior AcroDance (6-8yrs) @ 5-6pm
Breakdance Juniors (6-9yrs) @ 6-7pm
Breakdance Seniors (10-16yrs) @ 7-8pm
Child's Full Name
*
First Name
Last Name
Child’s Age
*
Date of Birth
*
Address
*
Street Address
Street Address Line 2
City
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Medical / Allergy Information
*
I AGREE FOR MY CHILD’S PHOTOGRAPH, VIDEO FOOTAGE OR AUDIO TO BE TAKEN BY TOGETHER WE DANCE FOR USE IN MARKETING, PR AND PUBLICATIONS
*
Yes
No
Emergency Contact 1 (name & number)
*
Emergency Contact 2 (name & number)
*
Please tick YES to confirm your booking (no payment required at this stage)
*
YES
No, I don’t want to book
View our term dates & fees info here:
https://togetherwedancewexford.com/page/fees-and-term-info
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