Starmakerz Theatre School Leatherhead Registration Form
Child’s Name
Date Of Birth
Parent/Guardian Name
Address
Post Code
Mobile
Home Phone
Email
School
Classes
Classes you would like your child to sign up to: -
Ballet
Drama
Modern
Musical Theatre
Singing
Street Jazz
Tap
Medical Conditions
Has your child got any medical conditions we should be aware of?
Is your child taking any medication?
Does he/she have difficulty with hearing/eyesight?
Does your child suffer with any allergies?
Is there anything else you would like us to be aware of?
Emergency Contacts
In the event you are unavailable please supply two alternative contact numbers:
Emergency Contact 1
Number
Emergency Contact 2
Number
Please confirm that you have read and agreed to the Terms & Conditions and Privacy Policy on the Starmakerz Website.
I Agree
Please tick this box and sign below to confirm your consent to photographs and video footage for use in promotional material.
I Agree
Your Full Name
Date
How did you hear about us?
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