Dancing Feet

Alison Dando School of Dance

Registration Form

Please complete this form a fully as possible. Please provide at least one email address as all correspondence will be sent via email.

All personal details provided are treated as confidential in compliance with the Data Protection Act 1998

Personal details and contact information

Child's name:

Date of birth:

School year group:

Address:



Postcode:

Home telephone number:

First mobile number:

Please indicate relation to child:

Second mobile number:

Please indicate relation to child:

Other contact number:

Please indicate relation to child:

First email address:

Second email address:


Emergency contact details

Please list below the details of the person we should contact in the unlikely event of an emergency during a lesson.

Contact name:

Relation to child:

Telephone number:


Medical information

Please complete the medical information listed below so that we can ensure your child can participate safely in lessons.

Name of child's doctor:

Address:



Please list any allergies:

Please list any medical conditions eg. Asthma, Epilepsy or Heart Conditions:

Please list any medication which your child requires:

Please give details of any previous or ongoing injuries:

In the extremely unlikely event of a medical emergency during a lesson, please note that emergency services will be called and the emergency contact immediately notified.

Please give details of any conditions, circumstances or any other information which we should be made aware of:


Consent

I give consent form my child to participate in dance lessons with Alison Dando School of Dance.

Due to the nature of dance training it may sometimes be necessary for physical contact in order to aid the teaching process and help with posture correction. Please do not hesitate to contact me if you wish to discuss this further.
I understand and accept the need for physical contact in the teaching process.

I give consent for my child to be referred for emergency medical treatment if required.

I give permission for my child to be photographed or filmed during dance displays / shows / classes. These may be used for advertising or to view on the school's website.

Any queries or concerns may be privately discussed with Alison at any time.


Registration form completed by:

Name:

Date:

Relation to child:

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Alison Dando School of Dance