Childrens Enrolment Form


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Please print off this page using your browsers print command

and then bring the completed form with you to enrol at Chiswick Theatre Arts

I would like to enrol________________________________Date of Birth__________________________

For the following classes _______________________________________________________________

______________________________________________________________

_______________________________________________________________

Name of parent/guardian ______________________________________________________________

Address ______________________________________________________________

______________________________________________________________

Postcode_______________________________________________________

Email ______________________________________________________________

Telephone Number Day ______________________________________________________________

Eve ______________________________________________________________

Mob ______________________________________________________________

Any medical conditions that we must be aware of eg. Asthma, diabetes, allergies, epilepsy etc

______________________________________________________________

I understand that due to the nature of dance, physical contact may be necessary by the teaching faculty.

I agree to pay termly, in advance

Signed _______________________________Date___________________________

Chiswick Theatre Arts 5a Devonshire Rd Chiswick W4 2EU Principal Georgina Burns