Midland Theatre Ballet Final Application Form

Twinkle Tots Ballet 2024: Free Trial Registration

Please provide as much information as possible in this form.
Student Name*

First NameLast Name
Parent/Guardian Name*

First NameLast Name
Student Date of Birth*

DayMonthYear
Date
Current Age*
Parent/Guardian Phone Number*
Email Address (the one used for all communication)*
Please provide us with some information.
Which select which class you are interested in (all take place in Sutton Coldfield)?*

Monday 9:30am - 10:10am (2yrs - 3yrs) - St Peter's Church (B72 1JJ)Monday 10:10am - 10:50am (3yrs - 4yrs) - St Peter's Church (B72 1JJ)Saturday 9:00am - 9:40am (2yrs - 3yrs) - St James' Church (B75 5BW)Saturday 9:40am - 10:20am (3yrs - 4yrs) - St James' Church (B75 5BW)Saturday 10:20am - 11:00am (2yrs - 3yrs) - St James' Church (B75 5BW)Saturday 11:00am - 11:40am (3yrs - 4yrs) - St James' Church (B75 5BW)
Do you have any ballet/dance experience? Please provide as much information so that we can allocate you to the correct class for your ability. Please do not worry if you don't have any experience - in which case please state 'Beginner'.*
How did you hear about Twinkle Tots Ballet?*
Medical Information
IMPORTANT: A parent/guardian must remain in the class for the duration of all classes for health and safety purposes and just in case of an emergency.
*If you/your child has an inhaler, Epipen or any other emergency medication, it is your responsibility to bring this along to all sessions - making sure that it is easily accessible and is named.*
Do you understand and agree that 1 parent/guardian per student must remain in the class during the classes for health and safety purposes?*

Yes, I understand and agree.
Is there any medical information/allergies that we need to know about? Please also list any emergency medication that students require.*
Parent Signature / or Student 18+ signature*

Clear
Policies
On occasion it may be necessary for Twinkle Tots Ballet to share student records and information with Twinkle Tots Ballet teaching staff and volunteers, such as medical/allergy information and contact details, to ensure the safety of all students whilst in the care of Twinkle Tots Ballet. Please confirm that you agree to any relevant information contained within this form being shared withTwinkle Tots Ballet staff members and volunteers if required.*

Yes, I give my permission.
Do you agree to Twinkle Tots Ballet storing all of the information contained within this form whilst enrolled in the school?*

Yes, I give my permission.
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Twinkle Tots Ballet 2024: Free Trial Registration

Please provide us with some information.

Medical Information

Policies