Registration Form
Full Name
*
First Name
Last Name
Date of Birth
*
-
Day
-
Month
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Carer Name
*
First Name
Last Name
Email
*
example@example.com
Contact Number 1
*
Contact Number 2
*
Emergency Contact Name (to be different from above)
*
First Name
Last Name
Emergency Contact Number
*
Special Requirements
Any special requirements (e.g. allergies, medical). Please inform your class tutor of any relevant medical history.
GDPR Consent
I consent for my information to be used to receive updates on right2dance classes; such as new programme and class cancellations.
Photo Consent part 1
I consent for the person named above to be photographed and filmed as part of their participation in right2dance classes.
Photo Consent part 2
I consent that these images can be used for website, social media, publicity and promotion by right2dance, Renfrewshire Council, One Ren and their funders/partners.
Date
-
Day
-
Month
Year
Date
Please verify that you are human
*
Submit
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