Anita's Dance Academy - School holiday dance explosion workshop registration form 11th July 2019
Please fill in all the details below to secure your spot in the workshop - we are running only 1 full day this holidays. Numbers are limited due to studio size.
In order to confirm your booking payment will be required either online (bank account below) or in a named envelope in cash to Anita at the studio. This form must be filled in by the parent, caregiver or guardian for the children you are registering for this workshop, you will be the emergency contact for the following children on the days they are at the workshop.
Parent or guardian name *
Your answer
Email address *
Your answer
Mobile phone number *
Your answer
Childs name *
Your answer
Age group *
Second child if applicable
Your answer
Age group
Third child if applicable
Your answer
Age group
My child or children have danced before *
Required
I have paid to secure the space for my child/children. First and last name as the reference and holiday as the particulars (bank details are 06 - 0773- 0241834- 00) *
My child has a medical condition or disability *
If you answered yes please specify the details
Your answer
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