Registration Form

Cary Court

Student Details

Name*

Date of Birth*

Your Address*

Postcode*

Primary Telephone*

Mobile

Email*

Any Physical/Health/Medical Conditions

Any conditions and what Procedure is required in an Emergency should Medical Condition arise:-

Children under 16 Years using an inhaler must have written permission from parent/guardian for pupil to use their inhaler during
class. Adults with back or knee problems, etc, will need to consult their doctor before commencing any adult class.

Class/Classes you wish to attend:-

I wish to attend;. (Please tick):-

BalletMonTueWedThurFriSat

Melody / Milligan BalletMonTueWedThurFriSat

TapMonTueWedThurFriSat

West End Modern JazzMonTueWedThurFriSat

Hip HopMonTuesWedThurFriSat

Adult Tap / Adult Jazz BalletMonTuesWedThurFriSat

Notes

Terms are charged per term. (In line with Cary Court Academic Calendar)

Please see timetable to view current classes

Payment

To qualify for a reduction of 10%, fees must be paid in full by first week of term or before new term commences (which ever applies). Late payments will incur the late payment fee. 15% discount on term total if three or more subjects are taken.

Terms notice in writing or terms fees before removal of pupils

The above information may be used for exam entries.
There may be occasions when we use pupil’s photographs for publicity i.e. Facebook other electronic media. If you have any objections please tick the box below. Any objections please inform me in writing.

I object to the use of pupil’s photographs for publicity

Other Dance Schools/Teachers

I hereby undertake that all due notice has been given to previous dance teachers/schools attended and that the student no longer attends any form of training with any other dance teacher/school. Also, the student will not attend any classes/private lessons with other teachers/dances schools, unless by prior approval where formal agreements have been entered into between teaching establishments.

I agree to all the terms and conditions above (please digitially sign below)

Name of Parent/Guardian*

Digital Signature of Parent/Guardian*

Date*

SpringSummerAutumn

Year*

This form collects personal data so we can assist with your request. For further information about how we manage your data please see our privacy policy.
I understand