Classes Registration Form

Please fill in your details and press the submit button to register for classes

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Student's Name

Use the Tab key to move to the next field to key your details

Age

Date of Birth

Address

Postcode

Home Telephone No

Please include area code

Mobile Telephone No

eMail Address

Use your current email address only

Emergency Contact Name

Emergency Contact No

Relationship

Health Club Membership No

If applicable

RAD PIN No

If applicable

ISTD PIN No

If applicable

Are there any medical conditions we should be aware of?

Doctor's Name

Doctor's Surgery Address

Doctor's Telephone No

Any other Comments

Please tick the boxes, select from the drop-downs and also key details to indicate the dance classes of interest and supply all other requested details

Class Required?

Location

Day

Class Time

Preferred Start Date

Step First with Lafour

Lafour First Steps

Ballet

Tap

Modern

Tap/Modern Combined

Funky Street Dance

Jazz

Lafour Theatre

I M P O R T A N T !

Please note that by submitting this form to Lafour,
you accept all of the terms, conditions and health regulations as set out in the
Lafour Terms and Conditions



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