Application Adult Weekly Classes

Adult Weekly Classes
Choose the classes you are interested in taking

DancerciseBarre BlastTap AttackShow Stoppers Choir
Details
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityCountry

Post Code
Nationality
Date of Birth

YearMonthDay
Email*
example@example.com
Phone Number
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Emergency Contact

First NameLast Name
Relationship
Emergency Contact Phone Number
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Medical Information
Do you suffer from any condition requiring medical treatment on a regular basis?
(ie: diabetes, asthma, epilepsy, depression etc)
Please specify:
Do you suffer from any allergies (or major dislikes e.g. certain foods, materials or medication)?
Please specify:
Have you received a tetanus injection in the last 5 years?

Personal Declaration

By attending our classes you agree to the following:
- Attending class in blocks of 5 weeks, Blocks are Paid in advance
- I agree that photographs/videos taken during the class can be used for future Jazzart publicity material
- I agree to participating in Fire Safety and Evacuation training at appropriate times
- I agree to receiving emergency medical treatment including anaesthetic as considered necessary by the medial authorities present
- Covid 19 guidelines remain monitored and changes to current policy will be posted on the notice board
Data Protection
It is essential that JazzartUK collects personal information about candidates

Access to this information is strictly controlled

Everbody has a right to access data held about them. In general, JazzartUK will abide by the Data Protection principals, information on which can be found on: www.dataprotection.gov.uk
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Date

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Date
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Adult Weekly Classes