Participant Registration Form
South East
Class location:
Parent/ Guardian Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Emergency contact number (should the above not answer)
-
Area Code
Phone Number
Email
example@example.com
Participant Name
First Name
Last Name
Date of birth
Age
School they attend:
Gender
Male
Female
Other
Prefer not to say
Ethnicity
Ethnicity information is collected to provide information to funding bodies for statistical purposes. This data is always provided to third- parties as quantified data only.
Any disability/ additional learning needs/ health information we need to be made aware of:
Do you give permission for us to share medical/disability information with authorised staff if needed (e.g - your student's teacher)
YES
NO
Do you give permission for UDOIT Dance Foundation to feature this participant in any photos/videos that are taken for publicity & promotional purposes only
YES
NO
Some attendees at events may film/ photograph for their own personal use (e.g parents of other participants)- do you consent to this?
YES
NO
UDOIT Dance Foundation collects data in order to provide classes to participants , by submitting information you are agreeing to the use of sharing data
E Sign
Submit
Should be Empty: