Application Form Ballet

Comments

This field is for validation purposes and should be left unchanged.

The class you are interested in is currently full. If you would like to be added to our waiting list, then please fill in the form and we'll let you know as soon as a space is available.

Class/activity applying for(Required)

Date Completed(Required)

Days available(Required)

Monday

Tuesday

Wednesday

Thursday

I would like to participate in Zoom lessons

Please tick which days you are available to join a class. Please tick as many as you can, to make it easier for us to allocate you a place.

Student Information

Student Name(Required)

First Last

Known As (if other)

Date of Birth(Required)

Current Class at School

Male/Female(Required)

Male

Female

Home Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Home Phone(Required)

Students Mobile

Parent's Email(Required)

This will be the email address used for correspondence. Please check that it is correct.

Parent / Guardian 1

Parent/ Guardian's Name(Required)

First Last

Parent/ Guardian's Phone(Required)

Parent/ Guardian's Mobile(Required)

Parent / Guardian 2

Parent/ Guardian's Name

First Last

Parent/ Guardian's Phone

Parent/ Guardian's Mobile

IN CASE OF EMERGENCY

Person To Call other than parent or guardian(Required)

First Last

This should not be the parent or guardian

Relationship

Emergency Contact's Phone(Required)

Emergency Contact's Mobile(Required)

MEDICAL

Medical Conditions

Please give details of any current/ongoing MEDICAL CONDITIONS or treatment we should be made aware of: ie. Prescribed medication, asthma, epilepsy, injuries etc

Doctors Details(Required)

Please enter the Name, Practise Address Phone Number of the Students Doctor.

Immunisations

yes

no

Is the student up to date with immunisations?

Allergies

Please give details of allergies or intolerances

Medical Terms & Insurance

Parent / Carers Name(Required)

Doctor Consultation(Required)

By ticking this box I agree & understand that it is my responsibility to consult with a doctor prior to enrolling my child in this class, should I have any concerns about my child’s health, and decide whether it is safe for him/her to participate.

Injury(Required)

By ticking this box I recognise that Stagestars classes require physical exertion that may be strenuous and may occasionally cause injury, and I am fully aware of the risks involved. I understand that Stagestars Scotland has public liability insurance, but if I require personal accident cover I will arrange this privately. I agree to assume full responsibility for any injuries, or damages, known or unknown, which may incur as a result of participating in Stagestars classes. I waive any right to claim compensation against Stagestars Scotland or the coaches, in case of injury or strains sustained during the class.

Personal Belongings

Personal Belongings(Required)

I understand that personal belongings are not insured by Stagestars, therefore I assume full responsibility for these and expect no compensation if items are lost or stolen.

Photography

Permission for Photographs or video to be taken

Name of child

First Last

Photos for Marketing

I give permission

I do not give permission

Do you give us permission for your child’s photo to be taken and used by Stagestars for photo displays or advertising such as the Stagestars Website or local newspapers?

Photos for Social Media

I give permission

I do not give permission

Do you give us permission for your child’s photo to be taken and used by Stagestars for Facebook, Instagram and Twitter?

Safeguarding Children

Safeguarding Children(Required)

I have read and understood the procedures regarding Safeguarding children.

See this page Safeguarding Children (opens in a new window)

By indicating that you give permission for your child to walk home on his or her own, even if they are under 16 years of age, you agree to take full responsibility for your child once they have left Stagestars School.

Walking Home Unattended

I give permissions for my child to walk home on his/her own, even if they are under 16 years of age

I do not give permission for my child to walk home on his/her own

By indicating that you do not give permission for your child to walk home on his or her own, please indicate below people who you give permission to collect your child:

Unattended Collection Person 1

First Last

Named persons (other than parents) I give permission to collect my child if I am unavailable

Person 1 Phone

Person 1 Relationship

Unattended Collection Person 2

First Last

Named persons (other than parents) I give permission to collect my child if I am unavailable

Person 2 Phone

Person 2 Relationship

Unattended Collection Person 3

First Last

Named persons (other than parents) I give permission to collect my child if I am unavailable

Person 3 Phone

Person 3 Relationship

Any Other Information?

If there is any other information you think we should be aware of please add it here.

Terms and Conditions

Mailing List(Required)

I agree to my email address being added to a mailing list. This will only be used by Stagestars for essential communication.

Registration(Required)

I have read and agree to the Registration terms

Please read our Registration Terms here (opens in a new window).

Automated reply

You should receive an email reply from us, giving you more details on this class, once you have submitted this form. If you do not receive this, please check your junk folder and if it is not there please email seonaid@stagestars-scotland.com as we will otherwise be unaware that you have not received it. Many thanks and we look forward to welcoming you to Stagestars.

Application Form

Dance - Ballet

Student Information

Parent / Guardian 1

Parent / Guardian 2

IN CASE OF EMERGENCY

MEDICAL

Medical Terms & Insurance

Personal Belongings

Photography

Safeguarding Children

Terms and Conditions

Testimonials

NEWSLETTER SIGN UP

You have Successfully Subscribed!