Registration/Signup Form Go backYour message has been sent Student First Name(s)(required) Warning Surname(required) Warning Date of Birth (DD/MM/YYYY) (required) Warning Age (under 18 only) Select one option 18 months 19 months 20 months 21 months 22 months 23 months 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Warning Medical Conditions/Allergies/Injuries Warning Previous Dance Experience (if any) how many years? Warning Emergency Contacts Parent/Guardian (Adult Next of Kin)(required) Warning Surname (required) Warning Address (required) Warning Email (required) Warning Emergency Contact Number (required) Warning Parent/Guardian 2 (adult classes not required) Warning Surname (adult classes not required) Warning Address (adult classes not required) Warning Email (adult classes not required) Warning Emergency Contact Number 2 (adult classes not required) Warning Class/classes you want to enrol in: I offer one free class on initial trial. All under 18’s classes after that I ask for a terms commitment when deciding to sign up (approx 12 weeks) Ballet Ballet – Level 1- Mullion (Friday 15.45 – 16.45) Ballet – Level 1- Gweek (Saturday 9.00 – 9.45) Ballet – Level 2 Coverack (Monday 16.00 – 17.00) Ballet – Level 2 Mullion (Friday 16.45 – 17.45) Ballet – Level 2 Gweek (Saturday 10.30 – 11.15) Ballet – Level 3 The Lizard (Wednesday 16.00 – 17.00) Adult Ballet Coverack (Monday 18.00 – 19.00) Warning Contemporary Contemporary Ages 8+ The Lizard (Thursday 17.00 – 18.00) Warning Jazz/Musical Theatre Musical Theatre/Jazz ages 4-11 The Lizard (Thursday 15.45 -16.45) Jazz Ages 8+ Coverack (Monday 17.00 – 18.00) Jazz/Contemporary Ages 8+ Gweek (Saturday 12.00 – 13.00) Warning Street/Commercial Junior Street/Commercial ages 8 – 11 Mullion (Friday 17.45 – 18.45) Junior Street/Commercial ages 8 + Gweek (Saturday 11.15 – 12.00) Senior Street/Commercial (Year 7+) The Lizard (Thursday 18.00 – 19.00) Warning Yoga Yoga (Adult) Coverack (Monday 19.00 – 20.00) Warning Tap Tap Ages 8+ The Lizard (Wednesday 17.00 -18.00) Adult Tap The Lizard (Wednesday 18.00 – 19.00) Warning Choose several options Yes No Warning Names of other children Warning Adult classes Termly (10% off) (adult classes only) 'Pay as you go' (adult classes only) Warning *Term times vary sightly from term to term. They are listed in the ‘Timetable’ section on the website but are usually around 11-14 weeks. Do you consent to the use of photography and videography of your child (or self) for performance social media and marketing purposes?(required) Yes No Warning Do you wish to participate in our annual summer performance?(required) Yes No Warning Warning! SubmitSubmitting form Δ
Miss Jarry's School of Dance