Registration Form

To be completed by a parent/carer if the named dancer is under 18 years of age.

Dancers Name

First Name

Last Name

Age and Date of Birth

Class

Please select the class the dancer will be attending:

Verwood Foundation, Age 4 - 7 (School Years R - 2)

Verwood Foundation, Age 7 - 11 (School Years 3 - 6)

Ringwood Foundation, Age 4 - 7 (School Years R - 2)

Ringwood Foundation, Age 7 - 11 (School Years 3 - 6)

Ringwood Foundation, Age 11 - 16 (School Years 7 - 11)

Adult Foundation

Advanced Class

Popping

Parent/Carer email if the dancer is under 18 years of age.

Contact Telephone Number

Parent/Carer number if the dancer is under 18 years of age.

Address

Emergency Contact Name 1

Emergency Contact 1 Number

Emergency Contact Name 2

Emergency Contact 2 Number

Medical Information

If we need to know about any medical conditions or allergies, please provide details including any medication needed.

Additional Information

In order for us to be as inclusive as possible please let us know any additional information around any support needs (for example learning needs and/or adaptations).

Terms and Conditions

FEES Following a free trial class, if a dancer would like to join, an invoice for the remainder of the half-term will be issued. Invoices will then be issued ahead of each half-term via email, with payment due prior to the first class. There will be no concessions or deductions for classes not attended. If a dance class has to be cancelled for reasons out of our control, refunds will not be given but we will arrange a replacement class at a later date. ATTENDANCE Commitment, good attendance and punctuality are expected throughout the term. Parents/Carers must make arrangements for children to be brought to and from the classes safely. BEHAVIOUR For the safety and enjoyment of everyone, dancers are expected to behave in a friendly and respectful manner to all dancers and staff members. If a teacher feels the behaviour of a dancer is disruptive to the enjoyment and education of others, their parent/carer will be called to collect their child. PHOTOGRAPHY AND FILMING Staff at Shake may video and/or photograph classes, performances and competitions, both to support training and for marketing and publicity purposes, including on Shake's social media channels. Shake will not publish the full names or personal information of any dancer with any photograph or video. If you do not consent to your child being photographed or filmed the director must be notified in writing.

I agree to the terms and conditions as outlined above. I understand it is my responsibility to inform Shake in writing of any changes to the information I have provided on this form.

Signature

Please type full name in the box below. This must be completed by a parent/carer if the dancer is under 18.