ATTITUDE DANCE ENROLMENT FORM

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FULL NAME OF CHILD *

CHILDS DATE OF BIRTH - DAY / MONTH / YEAR *

FULL HOME ADDRESS *

POST CODE *

ANY ALLERGIES/ MEDICAL DISORDERS OR CONCERNS? *

YES

Required

IF YES PLEASE DESCRIBE:

MEDICAL CONDITIONS

Please inform a member of staff if your child has any medical or learning difficulties, as it is important for the teacher to be aware for the happiness and safety of your child.

All information is confidential and will be kept in Attitude Dance records incase of an emergency.

*PARENTS DETAILS*

PARENTS/ GUARDIAN NAME(S) *

PARENTS / GUARDIAN NUMBERS(S) *

PARENTS / GUARDIAN EMAIL(S) *

EMERGENCY CONTACT NAME(S) *

EMERGENCY CONTACT NUMBER(S) *

PLEASE READ CAREFULLY

I the above parent/ guardian have read Attitude Dance rules and regulations page. I fully understand and support these rules and I am happy for my child to attend weekly classes. I also will not hold Attitude Dance Responsible in the unlikely event of any injury caused to my child.

I have also fully read the data protection form provided by Attitude Dance Studios LTD. I have been made fully aware of what this is and give my full permission for Attitude Dance to contact myself using my details I have provided for any use they may wish to use them for.

I also give permission for Attitude Dance to use any video or picture taken of my child for Attitude Dance promotion on social media, shows or Attitude Dance website etc.

ABOVE STATEMENT *

I CONSENT TO THE ABOVE STATEMENT

Required

DATA PROTECTION CHANGES

Due to changes in data protection regulations (GDPR) which come into effect on 25th May 2018. We must ask our students and parents to review their marketing preferences to ensure they don't miss out on future marketing communications. PLEASE NOTE: students aged 13 and above are required to enter details and sign in accordance with GDPR.

PLEASE enter your current details below for each method of communications you agree to us using:

Email? *

YES

Text Message? *

YES

Telephone? *

YES

Social Media? *

YES

DECLARATION

These data preferences will be used by Attitude Dance only, in the process of our normal work. They will not be shared with a third party.

1. I certify that my child is physically fit and have not been advised to not participate in any form of exercise by a qualified medical professional. I certify that there are no health related reasons or problems which preclude active participation in a dance workout related activity. *

Yes

Required

2. I will not hold Attitude Dance or instructors responsible for any unlikely injury/ illness caused to my child. *

Yes

Required

3. I am not being forced to take my child to attend classes at Attitude Dance. This is my own /my child’s decision. *

Yes

Required

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND FULLY UNDERSTAND THE CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY, A CONTRACT AND I SIGN IT OF MY OWN FREE WILL. *

I consent to the above statement.

Required

THANK YOU AND WELCOME TO ATTITUDE DANCE

DAVID & THE TEAM

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