Registration form
Please complete this form online or hard copy and give it to your dance leader before you start the lesson, you will not be able to participate in any activities unless you do so. (if you need a printout, one will be provided). If you have any difficulties please contact victorialouisedance@gmail.com
Sign in to Google to save your progress. Learn more
Participants full name 
Participants full address
Mobile number (Parents or Guardian if under 16 yrs.):    
Date of birth
MM
/
DD
/
YYYY
Email address (Parents or Guardian for under 16 yrs)

Emergency contact name and relation: 

 

Emergency contact number:

Any Medical conditions/ allergies (Including medication)

If you have ticked yes to the above question please explain in more detail

Any access needs 

If you have Ticked yes to the above question could you explain in detail the participants needs

If under 16 name and number of person collecting participant: 

Print and sign this document please to take part in any lessons with Victoria Louise Dance.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms