Miss Jolene's Sch ool of Dance
07528014855
More
Home
Registration Form
Miss Jolene's Live
Body, Mind and Skin by Jo
Contact Us
News
Miss Jolene
Primary School Partnerships
Uniform
Client Feedback
Where to find us
Blog
Acrobatic Arts
About
Registration form for Miss Jolene's School of Dance 2020/2021
Parent Name
Student Name
Student DOB
Address
Address 2 (optional)
Contact Number 1
Contact Number 2
Contact Number 3 (optional)
Primary Email Address
Email 2 (optional)
Name of person/s responsible for dance fee payments
Medical Information to be recorded
Allergies to be recorded
Anything else
Class/es I am enrolling for
We require your consent before photographing/recording your child during a Miss Jolene's School of Dance Class or Event. Please read through the following statements carefully and acknowledge your decision. Your child will NOT be photographed/videoed during the trial period. You can change you decisions at any time by emailing us at
[email protected]
I give consent for my child to be photographed/videoed at Miss Jolene's School of Dance Class or Event
YES
NO
I give consent for my childs image to be used in printed publications, such as posters, leaflets, newspapers
YES
NO
I give consent for my childs image/video to appear on Miss Jolene's School of Dance Website
YES
NO
I give consent for my childs image/video to appear on Miss Jolene's School of Dance Social Media Platforms
YES
NO
Please send me a uniform order form
Yes Please
No
Send Message
Thank you for contacting us. We will get back to you as soon as possible
Oops. An error occurred.
Click here
to try again.