Principal: Jason Thomas R.A.D.R.T.S (CERT ED),A.I.D.T.A,
t : 01872276365 m : 07766447937 e : info@jasonthomasdance.co.uk
www.jasonthomasperformingarts.co.uk www.danceschoolbude.co.uk
Registration Form
Name of pupil: | ||
Address: | ||
Post Code: | ||
Daytime Telephone: | Evening Telephone: | Mobile Telephone: |
Date of Birth: | ||
E-mail address: | ||
How did you hear about us? (If a pupil from the school recommended you please put their name): | ||
Please state below any relevant medical details of which the School should be aware. Please note that no member of staff will be permitted to administer any medication to any pupil whatsoever. In the case of medical emergency an ambulance will be called: | ||
Please state below which classes your child wishes to attend
Total payment | Cash / Debit Card / Credit card | |
Photos and videos are frequently taken in class. Photographs and videos may be used for publicity
purposes. Please sign in the box below if you agree to this
Signature of Parent/Guardian/Pupil: …………………………………………………………………………………………………………… |
For school use only : Monies received: Receipt No: | ||
Joining Date: | Class Attending: | Centre: |
I confirm I have read and understand the Terms and Conditions of Jason Thomas Performing
Arts Studios and I hereby request that you enrol my Son/Daughter/Self (delete as applicable) as a pupil.
Signature of Parent/Guardian/Pupil: ………………………………………………………………………………………………………………
Name in print of Parent/Guardian/Pupil: ………………………………………………………………………………………………………
Data Protection Act 1998: Information you provide will be held securely & in accordance with the Data Protection Act
1998. It will not be disclosed to any 3rd party other than The Royal Academy of Dance and any other relevant Dance
Organisation without your prior written consent unless there is a legal requirement to do so.
Truro - St Ives - Wadebridge - Bodmin - Fowey - Portreath - Bude