Summer Workshop Registration Form

Registration Form

Join our exciting summer workshops designed to inspire, challenge and build confidence in dancers of all levels. Our 2-Day Dance Fun Workshop (age 7-11) explores a variety of styles with high-energy choreography to hits from The Greatest Showman, while our 3-Day Ballet Intensive (age 12+, classically strong 11-year-olds to be considered) focuses on conditioning, technique, pointe preparation, and ballet variations to develop strength, artistry, and confidence in ballet training. LOCATION: Island Arts Centre The Island Lisburn BT27 4RL PRICE: 2-day workshop- £50 (2 Days) £27 (Day) 3-day ballet Intensive- £123 (3 Days) £45 (Day Wed/Fri) £35 (Half Day Thur) Dance Conditioning Day
Course*
Student Name*

First NameLast Name
Birth Date*

MonthDayYear
Parent/Guardian Email*
example@example.com
Parent/Guardian Phone Number *
Emergency Contact Number*
Emergency Contact - Please add name and relation to student*
Student's last exam syllabus (FOR BALLET INTENSIVE ONLY)
E.G. ISTD, RAD, IDTA, BBO
Are you currently trained in pointe work? If yes, how long have you been training en pointe? (months/years) (FOR BALLET INTENSIVE ONLY)
Dance school currently attending*
3 Day Ballet Intensive - Attendance Option

3 Days2 Days1 Day (Full Day)1 Day (Half Day – Thurs)
If not attending all 3 days, please state which day(s)
Wed 22nd, Thur 23rd or Fri 24th
2 Day Dance Workshop - Attendance Option

2 days (Mon - Tues)1 day (Mon 20/7)1 day (Tues 21/7)
Injuries & Medical Information*
Please use this box to tell us of any injuries or medical conditions that we should be aware of. If you do not have any, then please write 'None'.
Photographic Consent Form: As part of our Summer workshop program, we may occasionally take photographs or videos of enrolled students. These images may be captured during classes, workshops and could be used to promote our programs via our professional social media platform, marketing materials, and other promotional content. By giving your consent, you agree to the following: I grant Jade H Dance Coaching, including its representatives and employees, permission to capture photographs and/or videos of me in connection with the course I am enrolling in. I authorise Jade H Dance Coaching, its assignees, and transferees to retain exclusive rights to these images, including the right to copyright, use, and publish them in print and/or digital formats. I understand and agree that these images may be used—with or without my name—for any lawful purpose, including but not limited to publicity, marketing, illustration, advertising, and online content.*

YESNO
Please pay the deposit amount to secure your place on the course *
Payment details will be sent by email once this form has been successfully submitted.
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