Adult Class Registration
For adults over 18 years - no upper age limit
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First Name(s) *
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Surname *
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Any relevant medical information or injuries
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Email *
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Mobile Telephone *
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Home Telephone
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I am 18 years or over *
Emergency Contact Information
Please provide a name and contact number in case of emergencies.
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Telephone Number *
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Terms & Conditions
Any person who participates in dance classes or courses provided by Deborah Hoskins Dance shall do so at his/her own risk. He/she shall assume all risk involved, including but not limited to all loss or stolen property, cost, claim, injury, damage, or liability sustained while participating. Deborah Hoskins Dance will not be held liable for any misfortune that may occur.

The participant agrees to inform the class instructor of any relevant injuries or health issues.
Participants acknowledge that there are inherent risks in taking physical exercise and there is no medical reason they cannot undertake any dance programme.

The information provided in this form will be treated confidentially and will be used for administration purposes only. No information will be released to any external party.

By ticking below, you are agreeing to the above and are certifying that you understand the nature of physical activity involved in dance activities and certify that you are in good health and have consulted a doctor before beginning this dance program if necessary.

I have read and understood the terms and conditions *
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You can change your mind at any time by clicking the unsubscribe link in the footer of any email you receive from me, or by contacting me at deborah@deborahhoskinsdance.co.uk. I will treat your information with respect. For more information about my privacy practices please visit my website http://www.deborahhoskinsdance.co.uk/about/privacy-policy-2/. By submitting this form, you agree that I may process your information in accordance with these terms.

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