Holiday workshop sign up form

Summer Workshop Application Form

Name of student

Age

School year

Please tick which day(s) you would like to attend:

Tuesday 23rd July (day of dance)

Wednesday 24th July (musical theatre)

Thursday 25th July (musical theatre)

Parent/guardian's email address:

Emergency contact 1 (phone number)

Emergency contact 2 (phone number)

Does your child have any medical conditions or allergies that we need to be aware of? If yes, please give details.

During the workshop we may take photos and videos to use on our website and social media. Please indicate below if you are happy for us to use your child's image on the following platforms:

Website

Social media i.e. FB, Instagram

Flyers or other promotional material

No photos

If your child is in Year 7 or above and you are happy for them to leave at the end of the day without a parent or guardian, please tick the box below. (If the box is unticked, students will not be allowed to leave until collected).

My child is in year 7 or above and has permission to leave at 3pm without a parent/guardian

If someone unfamilier to the Dragonfly teachers is collecting your child, please provide us with a collection password:

Lloyds Bank

Dragonfly Dance and Performing Arts

30 99 50

82359060

Reference - 'Summer child's name'

One day = £35

Two days = £60

Three days = £90

Thanks for registering for our Summer Workshop.

See you there!