Registration form

CHILD’S NAME:……………………………………………………………………………………………………… NAME OF PARENT/GUARDIAN:………………………………………………………………………. PARENT/GUARDIAN EMAIL ADDRESS:………………………………………………………. PREFERRED CONTACT NUMBER:……………………………………………………………………… EMERGENCY NAME & TELEPHONE:………………………………………………………………. CHILD’S D.O.B & AGE:………………………………………………………………………………………. PREVIOUS DANCE EXPERIENCE (IF ANY): MEDICAL/PHYSICAL CONDITIONS/ALLERGIES (IF ANY): As far as I am aware my child is medically fit to take part in this activity. I understand that payment is non-refundable or deductible. I have read, understood and agree with the terms and conditions letter, I have signed and returned the Disclaimer form to Holly’s School of Dance. I consent to Holly’s School of Dance contacting me via the details provided above and agree that these details will be kept for as long as my child attends Holly’s School of Dance classes/workshops. Signed………………………………………………. Dated……………………………..