Childs Name
Childs Dance Class
Childs Age (at date of the first show)
Local Residing Authority / Council
Does your child have allergies? —Please choose an option—YesNo
Childs allergies:
Does your child use an Inhaler/Epi pen? —Please choose an option—YesNo
Device your child uses:
Does your child take any medication? —Please choose an option—YesNo
Medication your child takes:
Does your child have a hearing/visual disability? —Please choose an option—YesNo
What hearing/visual disability your child has:
Does your child have a physical/learning disability? —Please choose an option—YesNo
What physical/learning disability your child has:
Parents Mobile Number:
Parents email
We would be grateful for any help backstage with your children during this very busy and fun weekend. Please contact Sasha directly on 07809235614 and let her know what shows you would like to offer your help.
Please confirm if you have a DBS less than 3 years old: —Please choose an option—YesNo
Your DBS Certificate Number:
I confirm as a parent, I have no concerns that would prohibit my childs ability taking part in this production (sign in the white box below) Clear
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