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Inclusive Dance Sign Up Form
- ASCEND Classes will be re-starting running every two weeks.
FREE Tuesdays 5:15pm - 6pm
April: 28th
May: 12th
June: 2nd, 9th, 23rd
July 7th, 21st
Classes break for August and continue in September
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Email
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which sessions would you like to book onto?
April 28th
May 12th
June 9th
June 23rd
July 7th
July 21st
Your full name
Your answer
Child's full name
Your answer
Age of child
Your answer
Will your child be attending with
A parent
A carer or support worker
Independently but we will stay on site / in the room
Independently
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Please give some infomation about your child's diagnosis
Your answer
Please give some information about your childs communication needs and preferences
Verbal
Non Verbal
AAC Symbols
PECS
How can we best support your child during the session?
Your answer
Are there any triggers / sensitivies we should be especially aware of
Your answer
Any favourite songs / songs of music styles they don't like?
Your answer
Emergency Contact 1
Your answer
Emergency Contact 2
Your answer
Does your child have any allergies?
Your answer
Please give your child's GP's name, surgery and contact number
Your answer
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