Enrolment & Media Consent
Symphony Dance School Enrolment and Media Consent Form
Student's Full Name
Date of Birth
Parent/Guardian : Name
Parent/Guardian : Telephone Number
Parent/Guardian : Email Address
Address of Student including Postcode
Alternative Parent/Guardian Contact Information
Allergies / Medical Conditions
Tuesday @ Number 8 - Miss Denny
Wednesday @ St. Peters - Miss Denny & Miss Sarah
Friday @ Kempsey - Miss Sarah
Saturday @ St. Peters - Miss Sarah
Saturday @ St.Peters - Miss Vicky
Saturday @ Number 8 - Miss Denny
Saturday @ Number 8 - Miss Vicky
Yes, The Student's Image may appear on the Symphony Dance School Website
Yes, The Student's Image may appear on any Social Media Platforms run by Symphony Dance School
No, The student's Image may not be used in any way
Footage of Performances (such as Summer School) can include my child to only be distributed to other families involved with the performance.
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