Participant Registration Form 2022-2023
Thank you for your interest in dancing with us. Please complete the following form so that we can support you during your time dancing with us.

It is a requirement of our funders that we gather certain personal information. If you do not wish to supply us with this information, we may not be able to include you in our classes.

Sign in to Google to save your progress. Learn more
Todays Date / Date of completing form *
MM
/
DD
/
YYYY
Which class are you registering to be part of? *
Title
Full Name: *
Age Range: *
Required
Gender *
Postal Address *
Telephone Number (Mobile and/or Home) *
Email Address (if you use one) We will use this occasionally to keep in contact with you if you are happy to do so.
Would you like to be added to our mailing list, to be keep informed about our classes and receive a regular e-news bulletin? (You can opt out at any time)
Clear selection
Emergency Contact: Name & Relationship, Phone Number and Email *
Ethnicity *
Required
Do you consider yourself to have a disability? *
Required
Please let us know of any access requirements, needs or medication we should be aware of: *
Do you have any allergies or intolerances we should be aware of? *
Do you take part in any other physical activity? *
Required
If yes, what activities do you take part in? How often do you do this?
Have you experienced work by The Dance Network Association before? *
Required
By way of an electronic signature, please tick the box below to confirm all information is correct and  confirm you are happy for The Dance Network Association to retain your information. *
Required
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of The Dance Network Association. Report Abuse
Google Forms