Breakdancing Kids aged 4-7 Registration
Please read our Student's Guidance & FAQ via this link: http://bit.ly/StudentGuidanceFAQ
Email address *
Student's Full Name: *
Your answer
Student's Date of Birth: *
dd/mm/yyyy
Your answer
Home Post Code *
Your answer
School Attending:
Your answer
Known allergies, previous injuries or other conditions. (if none, write NONE) *
Your answer
Do you or your child have any special accessibility requirement? (if none, write NONE) *
Your answer
Parent / Guardian Information
We will contact you with any information regarding the sessions and in the event of an emergency.
Your Name: *
Your answer
Relationship to Student: *
Your answer
Mobile Number: *
Your answer
Second Emergency Contact
Please provide a second contact in the event of an emergency
Emergency Contact Name: *
Your answer
Relationship to Student *
Your answer
Emergency Contact Number: *
Your answer
Do you have any of the following? *
We aim to help families and young people in need of support. If you have any of the following, you may qualify for a subsidised entry. Please bring a proof of your address and the relevant document(s).
Required
Where did you hear about us? *
After choosing an option, please specify details in the next question.
Continuing from above, please lets us know specific details *
ex. Facebook page ad / recommended by Craig David / picked up a leaflet in... / I googled: funky classes in...
Your answer
Consent and Sign
Our organisation complies with Child Protection, DBS checked and Insured.
We take photographic and video images during our classes, workshops and performances. These materials will be used accordingly to the Child Protection to reasonably promote and raise awareness of Funk Format. Such materials include printed and online publications, social media, audiovisual, digital and electronic materials, and any other applications we may use in the future. The copyright of any material which is generated as a result of these photographic and video activities shall be assigned and shall be the property of Funk Format and Funk Format Trust. *
Required
Information contained on this form WILL NOT be disclosed to anyone outside of Funk Format and Funk Format Trust. *
We will use your information [for administration purposes] and will only process your personal data in accordance with current data protection legislation.
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I have read and agree to the http://bit.ly/StudentGuidanceFAQ *
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To sign the agreement please tick the box *
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