Enrollment Form

Childs First Name

Guardian's Full Name

Child's Last Name

Birthday

Phone (Must be emergency number)

Street Address

Street Address Line 2

Town/City

County

Post Code

Are there any existing injuries or medical conditions which the student has which we should know about? If yes, please provide details

For our more technical classes we may be required to adjust posture or alignment for our students to understand how to execute a movement correctly - please indicate that this has your consent.: In the event of an accident we may need to administer first aid to your child - please indicate that this has your consent.: Periodically we may take photographs/films of children/parents/guardians taking part in our classes.These are purely for Anna Rose Dance School's marketing purposes and to show progress in class - please indicate if this has your consent.

Thanks for submitting your enrollment form!