Dance Registration Form

Inspire Dance By Amy Registration Form.

2025/2026
Students Name

First nameMiddle nameLast name
Parent/Guardian

First NameLast Name
Students DOB
E-mail
Phone Number

Area CodePhone Number
Gender
Address

Street Address

Street Address Line 2

City

Postal / Zip CodeCountry
I hereby give consent for my child to be photographed/filmed for the purpose of online advertisement and social media content.

Signature

I understand that through dance my child may be open to light injury.

Signature

I have been made aware that classes are paid in advance and no deductions are made for my child's absence at any given class.

Signature

All information provided and conversations between teacher and guardian are strictly confidential.

Signature
Type of Dance

Other
£5 Enrolment fee to be paid upon registration
Please advise if your child ___________________________ suffers from any allergies or medical conditions. As required please advise in the comments section below.
Comments
Payment method
Signature
Should be Empty:

Inspire Dance By Amy Registration Form.