Name of Student * Email Address * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Student DOB * Telephone Number * Alternative Tel number Which class or style would you like to book? Medical Conditions/Allergies Please discuss any medical conditions with your child's teacher Child's local education authority Durham Gateshead Newcastle Upon Tyne Northumberland Other How did you hear about us * How did you hear about us Recommendation Social media Google Workshop Leaflet Yell Other Please confirm below * I agree to keep the school updated with current emergency contact details and medical information Social Media * I agree to my child’s photo being used publicly on social media I agree I do not agree T & Cs * I accept I will be added to the email list and whatsapp broadcast list in order to receive communications from the dance school. I confirm I have read and agree to all school policies Thank you. Natasha will be in touch to confirm availability & start dates Or you can contact us viaPhone: 07359 102333Email: hexham@elainepygall.co.uk
