EmailMe Form - REGISTRATION FORM 2024

Dancers Name *

First Last

Date of Birth *

DD / MM / YYYY

Please tick one Class Only

	Wednesday 3.15pm to 4.15pm	Saturday 11.30am to 12.30pm
Ages 4 to 8 yrs: Rosette/Intermediates

Please tick one Juvenile Class Only

	Wednesday 4.15pm to 5.15pm	Saturday 12.30pm to 1.30pm
Ages 9 to 12 yrs: Juveniles

	Friday 5.30pm to 6.30pm
Ages: 13 to 15 yrs Juniors Class 1

Please enter parent or legal guardian information here

Name *

First Last

Mobile Phone Number *

Email *

Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Any medical condition/circumstances you wish the school to be aware of:

WEBSITE/SOCIAL MEDIA *

	Yes
I give permission for my child's/children's image/photo/performances etc to be used by the Jennie Brady School of Dance for media publication

GDPR *

	Yes
In accordance with the EU (GDPR), we advise that the above data is the only data that we hold & store in respect to each student.We will NOT pass on this data to any third parties. Please indicate that you have read and agreed to this.

Parents/Guardians Signature