EmailMe Form - Modern Dance Exam Classes

Your Email *

Please supply an email address that is checked regularly, preferably a personal address and not a work address.

Applicants Name *

First Last

Student date of Birth *

DD / MM / YYYY

Male

Female

House/Apartment No. *

Street Address *

Address Line 2

Town *

County *

Eircode

Parent / Guardian Name 1 *

First Last

Parent / Guardian Phone 1 *

Parent / Guardian Name 2

First Last

Parent / Guardian Phone 2

Details of any Medical Condition, Special Needs or any other details that we should be aware of...
IF NONE PLEASE STATE SO *

Please list any related experience/training or any particular talents...

List any Performing Arts Schools attended Past / Present or any Representative / Agent you have in the Performing Arts Industry

How did you hear about WestSide?

Checkbox *

I consent to allowing Westside Performing Arts contact me by Email and/or Text Message.

Checkbox *

I consent to the data entered on this application to be stored on Westside Performing Arts Database.

Checkbox

I consent to photographs and/or video footage of the applicant been taking and stored for use in Casting Agency work (i.e. auditions for productions in TV, Film, Theatre) our schools prospectus or in other printed publications that we produce, as well as on our website and social media. The media may also visit our school to take photographs or film footage during an event. Students will often appear in these images, which may appear in local or national newspapers, or on televised programmes.