To book your 3 week trial, please complete the form below. A member of our team will provide you with a personalised class offer within 3 working days. Child's Name First Last Date of birth DD slash MM slash YYYY Gender Male Female Other Please detail if otherDo you have any previous dance experience?ISTD PinComplete if student has participated in previous ISTD dance exams.RAD PinComplete if student has participated in previous RAD dance exams.Parent/Guardian InformationParent Name First Last MobileEmail Are You Happy To Be Contacted? Mobile Email Select AllPlease let us know your preference. How did you hear about us? Word of mouth Social media Local event Google search Competition Other Medical informationDoes the student experience any of the following conditions? Anaemia, Migraine or Dizziness Anorexia, Bulimia or any other eating disorder Asthma or any other respiratory problems ASD, ADD, ADHD Allergies (e.g. Nut) Blood Disorder (i.e Anaemia or Haemophilia) Dislocation of a joint Epilepsy Osteo / Rheumatoid Arthritis or any other bone disorder Learning difficulties (e.g. Dyslexia) Sustained injuries in the last 3 months Other, please detail Detail if answered yesDeclaration I accept and understand that appropriate physical contact may be necessary within classes and hereby give permission for any teacher from Summerscales Performing Arts to do so. Any person teaching for Summerscales Performing Arts is required to complete formal training and undergo a Disclosure and Barring Service check. The information provided in this form will be treated confidentially and will only be used for administration purposes by Summerscales Performing Arts. No information will be released to any external party. I accept and agree(Required) Accept CAPTCHAEmailThis field is for validation purposes and should be left unchanged.
