Retina Dance Company Zomer Dans / Summer Dance 2015

Registration form / inschrijvingsformulier

    Group 1 and 2 are now full. If you are age 10 to 17, please email natalie@retinadance.com to be added to the waiting list

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    Contact details in case of emergency/Contactgegevens in geval van nood

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    Photo and film permission/Foto en film toelating

    Through completing this form you are giving Retina Dance Company the permission to photograph or film yourself/your child during the summer school. These images may only be used for Retina Dance Company publicity. If you do not give permission please contact Retina Dance Company. / Door dit formulier in te vullen geeft u Retina Dance Company de toelating om jouw/jouw kind te laten fotograferen of filmen tijdens de danslessen. Deze beelden mogen enkel en alleen gebruikt worden voor publiciteit van Retina Dance Company. Gelieve Retina Dance Company te verwittigen indien u dit niet wenst.