Registration form

Parents name*

Child's name*

Email Address

Date of birth* 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990

Address*

Postcode*

Telephone (home)*

Telephone (work)

Mobile

Is there anything I should know about yourchild's health that may affect his/her dancing*?

In emergency please contact*

Previous dance experience
(if any)*

Last exam taken

Previous teacher*

How did you hear about us

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