the space studio
student enrolment form
student information
name
*
first name
last name
age
*
date of birth
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
date
class(es) i would like to attend
*
contemporary dance (4-7 years)
contemporary dance (8-11 years)
contemporary dance (12+ years)
street dance (8-11 years)
yoga for children
private dance classes
does your child have any relevent medical history or information?
*
eg. asthma, epilepsy, heart conditions, allergies, neurodivergency etc
does your child have any sensory sensitivities or access requirements?
*
eg. sensitive to loud noises, people in close proximity etc
other information that may help me to support your child during our classes
parent/carer information
name
*
first name
last name
relation to child
mobile number
*
alternative number
eg. work or home phone
email address
*
alternative emergency contact
name
*
first name
last name
relation to child
mobile number
*
alternative number
eg. work or home phone
email address
photo and media consent
please note - your child will be notified to having their photograph/video taken at every occasion
i consent to photographs and videos being obtained of my child during classes
*
yes
no
the space studio will collect and use photographs and videos for the following purposes. please tick the box to confirm you agree to the use of photographs or videos of that specific purpose
for use on social media, such as 'the space studio' Instagram and Facebook pages
for use on 'the space studio' website (www.thespacestudio.uk)
for use in printed documents available to the public, such as promotional posters or leaflets
for documentation of choreography for rehearsal purposes, only to be shared with the above noted parent/carer and teachers of the space studio
i have read and understood the information. i agree to my childs photograph/video being used for the purposes i have confirmed above
*
yes
no
signature
*
date
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
enrole
Should be Empty: