REGISTRATION FORM | DS Archive

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PARENT / CARER FIRST NAME

PARENT / CARER SURNAME

PARENT / CARER EMAIL

PARENT / CARER PHONE

CHILD FIRST NAME

CHILD SURNAME

CHILD DATE OF BIRTH

CHILD ACADEMIC SCHOOL

CHILD MEDICAL CONDITIONS / ALERGIES / SEN

Please select the class(es) that your child will attend * Required

Tiny Stars (Ages 2 - 3)

Little Stars (Ages 3 - 4)

Intro to Ballet, Tap & Modern (Reception Year)

Ballet

Tap

Modern

Tap & Modern (SY 1 / 2 only)

Commercial

Lyrical

Acro

Musical Theatre

Drama

Progressing Ballet Technique

Pointe (SY8+ as advised by teacher)

NAME ON CARD

LONG CARD NUMBER

EXPIRY DATE (MMYY e.g. 0125)

CVC

ADDRESS YOUR CARD IS REGISTERED TO (Including door number and postcode)

I agree to the terms & conditionsView terms of use

Thank you for registering at Dancebox Juniors! We'll be in touch by email as soon as we have processed you onto our system.

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