Enrolment Form – Holiday Workshops.

To be completed and electronically signed by the parent/guardian in BLOCK CAPITALS

Name of student

Date of birth (DD/MM/YYYY)

Home address

Name of Parent/Guardian

Daytime Tel. No.

Mobile No.

Email

How did you hear about us?

What school does your child attend?

MEDICAL DETAILS

Name of Family Doctor

Doctors Tel. No.

Does your child suffer from any medical conditions that may effect their ability to take part in our classes? Please provide details of any medication that must be administred. If none, please write “none”

EMERGENCY CONTACT (alternative to parent/guardian named above)

Name

Tel. No.

Relationship to student

CONSENT TO PHOTOGRAPHY/FILMING

I give Take Flight Academy of Performing Arts permission to take photographs and/or video of my child. I grant Take Flight Academy of Performing Arts full rights to the use the images resulting from the photography/filming for publicity, including (but not limited to)ou, their printed and online publicity, social media platforms and press releases
I consent

I HAVE READ AND AGREE TO THE TAKE FLIGHT ACADEMY TERMS AND CONDITIONS

I accept the terms & conditions

SIGNED BY PARENT/GUARDIAN:

Print name