Health and Safety Form Please fill in this form if you wish to trial or join any of the Adult classes Please enable JavaScript in your browser to complete this form.Name *FirstLastContact Number (Mobile) *Email *Medical Information. Please note any medical problems, allergies &/or medication *Please state which class(es) you will be attending *Adult BalletAdult Tap (Experienced)Emergency Contact Details *FirstLastRelationship (eg Parent, Partner etc) *Emergency Contact Number (Mobile) *CONSENT TO RECEIVE INFORMATION BY ELECTRONIC MEANS (EMAIL OR SMS) *I AgreePlease tick this box if you consent for us to contact you by email or text with information regarding classes, invoices, shows, rehearsals, parent committee events and newsletters etc. We will process your data in accordance with our Privacy Policy. You may withdraw this consent at any time by emailing us.Photography *I give consentI DO NOT give consentFrom time to time you may be involved in events, shows, lessons and outings where photography or videos may take place. These photographs and/or videos may be used for publicity and/or marketing purposes. Please tick this box to give your consent to being photographed and/or filmed. You may withdraw this consent at any time by emailing us.How did you hear about us? *SignaturePlease type your name and this will be accepted as your signatureDate Signed (DD/MM/YYYY) *GDPR Agreement *I consent to having this website store my submitted information so they can respond to my inquiry.WebsiteSubmit
