IRIE! Registration Form

Please complete this registration form for EACH participant of an IRIE! class

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* 1. About you

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* 2. Age?

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* 3. Gender?

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* 4. Which Activity are you participating in?

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* 5. Have you ever visited The Moonshot Centre before

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* 6. How did you find out about us?

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* 7. Would you like to opt in to hear about more exciting events and opportunities by signing up to IRIE!’s mailing list? You can withdraw your consent at any time by emailing info@iriedancetheatre.com

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* 8. From time to time, IRIE! Will use pictures or videos of our workshops and activities to promote our services via our websites, on publicity posters or in our publications.

I grant IRIE! Dance Theatre full rights to use images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve the group’s aims. This might include (but is not limited to), the right to use them in

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* 9. Which race/ethnicity best describes you? (Please choose only one.)

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* 10. Do you consider yourself to have a disability or health condition?

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