to be completed by parent/carer

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* 1. Todays date

Date / Time

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* 2. Name of person completing the form 

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* 3. Address

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* 4. Parent/Carer Information

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* 5. Parent/Carer Information

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* 6. In the unlikely event of an emergency, please give one additional contact whom we could contact if we cannot get hold of either of the above parents/carers

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* 7. Date of birth (of dancer)

Date of Birth

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* 8. Gender (of dancer)

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* 9. Does your young dancer identify as having a disability?

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* 10. Does your young dancer have any allergy we need to know about?

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* 11. What is your young dancer's ethnicity?

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* 12. What school do you/your young dancer attend?

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* 13. Will your young dancer be travelling to and from the session alone?

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* 14. Do you give permission to be filmed/photographed? NB. young people are never identified by their full name.

  Yes No
For use on printed promotional materials
For use on the Greenwich Dance or partner websites
For use on Greenwich Dance social media platforms 
For use in performance/screenings/films 

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* 15. Are you happy for us to contact you with information regarding the session?

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* 16. Would you like to be added to our mailing list to receive news and updates from Greenwich Dance? Newsletters are sent monthly.

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