New Starter Registration | Gemini Dance Academy

Online New Starter Registration

NO Registration Fees

Dancer Full Name

Parent/Guardian Full Name

Which Dance school do you wish to attend:

Poppleton, York

Norton, Malton

Home Address

Email Address

Dancer Date of Birth:

Contact Phone Number:

Please List any medical Conditions:

Alternative details of Emergency Contact - Name/Number

Medical Consent: GDA will make evey effort to contact parents/guardians in the event of any illness/accident, however i have made the Academy aware of any medical conditions and i consent that in the event of any such incident, any necessary treatment can be administered to my child by a suitably qualified person. I understand that whilst every precaution possible will be taken by staff to ensue accidents do not happen, they cannot be held responsible for any loss or damage to property or injury suffered by my child.

I agree to the above declaration

Photo/Video Publication Consent: I give my permission for photographs/videos to be taken of my child whilst participting in Dancing at Gemini Dance Academy and/or reresenting the Academy in Competion/Championships and that such Photographs/Video can be used for the promotion of Gemini Dance Academy (Thi incldes Troupe/Group)

I agree to the Photo/Video Consent

By Ticking the box i confirmi have read and understood the above declarations and the information i have given is accurate:

Signature of Agreement

Thank you and welcome to Gemini Dance Academy!