Step Change Studios: Zoom Dance Classes for Disabled People (16+)
Register for our free virtual dance classes for disabled people. Classes take place every Saturday at 11am. Once you have registered, we will send you the Zoom class link. These classes are supported by Sense. By completing this form you agree to us sharing the information on this form for reporting purposes only. If you have any questions please email: info@stepchangestudios.com 

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First name & Surname *
Email *
Telephone
Postcode *
Date of birth *
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Emergency contact name and telephone number *
Gender *
Ethnicity *
Do you have a disability or long-term health condition? *
If you answered 'yes' to the above question, please provide details.
On average, how many days a week do you do 30 minutes or more of physical activity which is enough to raise your breathing rate?
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How did you hear about Step Change Studios
Photography/video – I give permission for Step Change Studios to use photos/videos from dance that I participate in for publicity (including social media). This will be used to help engage more dance participants and supporters. *
I understand that I am voluntarily participating in a dance class with Step Change Studios that will involve movement and physical activity. It is my responsibility to consult with a doctor regarding my participation. By selecting 'yes' to this statement, I am agreeing not hold Step Change Studios responsible for any injury or property damage that I may suffer as a result of my participation in any activity in connection with Step Change Studios. *
Name of parent/guardian if participant is under 18 or lacks capacity to consent.
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