Enrolment Form

Your Full Name

Your Date of Birth

Your Phone Number

Relationship To Child

Your Email

Child's Full Name

Child's Date of Birth

Child's Preferred Name

Does your child have any Speech & Language difficulties? Please give details:

Does your child have and Special Educational Needs? Please give details:

Has your child danced before and for how long? Please provide information about their most recent exam:

Does your child have any medical conditions or allergies? Please give details: ^

^Please ensure you have consulted a doctor accordingly before allowing you child to take part in any kind of physical activity.

Does you child take any medication they will need with them during a class/session?

Yes~

No

~Please give details

Is there any other information that you feel might be relevant?

Please upload any supporting documents or pictures below

Add a Document

Add a Photograph

Signature

Date

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