PK Performing Arts Classes
Permissions and Contact Form
Permissions
Childs Name
*
First Name
Last Name
Childs DOB
*
Any Medical/Allergies or learning difficulties please state
*
Second Childs Name (leave blank if n/a)
Second Childs DOB (leave blank if n/a)
Any Medical/Allergies or learning difficulties please state
Please list who has permission to collect your child/ren
*
Can we post on social media?
*
Yes
No
Emergency Contact Details
Contact One
*
First Name
Last Name
Mobile Number
*
Email
*
example@example.com
Contact Two
First Name
Last Name
Mobile Number
Email
example@example.com
Submit Form
Should be Empty: