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Student Information

Gender
Female
Male
Choose not to answer
Birthday
Day
Month
Year
Which class or workshop are you/your child enrolled in? (you may choose more than one)

Parent/Guardian Information

Medical Information

Do you/the student suffer from a health condition that impedes your/their ability to carry out dance activities?
No
Yes
Are you/the student currently taking any medications?
No
Yes

Acknowledgements

I acknowledge that participation in dance classes and/or dance workshops involves physical activity with inherent risks, and I voluntarily accept full responsibility for any injury or loss that may occur to myself/my child during classes run by Bolly Bandits.


By enrolling myself/my child into Bolly Bandits classes, I also consent to photos and videos of me/my child being used for any class practice or promotional purposes.


I confirm that I have read, understood, and agreed to the studio’s policies and procedures, and that I am the student, or parent/legal guardian of the child, named in this form.

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