DANCE CLASSES FROM BRIGHTLIGHTS!

DANCE CLASSES FROM BRIGHTLIGHTS!
Student Name*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Parent/Carer Name*

First NameLast Name
Parent/Carer Email Address*
example@example.com
Parent/Carer Phone Number*
2nd Phone Number in case of Emergency
Please enter a valid phone number.
Does your child have any medical conditions/allergies/injuries or other circumstances that we should be aware of?*

YESNO
If Yes please give details;
Street Dance - Mondays £5 a session - payable monthly or termly.

Ages 7 to 12 5.00pm-6.00pmAges 13 to 21 6.00pm-7.00pm
Ballet - Mondays £5 a session - payable monthly or termly.

Ages 13 to 21 5.00pm - 6.00pmAges 7 to 12 6.00pm - 7.00pm
Commercial Dance - Wednesdays £5 a session - payable monthly or termly

Ages 7 to 12 5.00pm - 6.00 pmAges 13 to 21 6.00 pm - 7.00pm
**NEW** TAP - Wednesdays £5 a session - Payable monthly or termly

Ages 13 to 21 5.00pm - 6.00pmAges 7 to 12 6.00pm - 7.00pm
PLEASE PAY HERE FOR YOUR 2 TASTER SESSIONS.
BrightLights Dance*
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2 taster sessionsTHIS IS TO BOOK YOUR NO OBLIGATION TASTER SESSIONS.
£10.00 Quantity

Total

£0.00

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