Student Information Class ---Preschool BalletBalletBody Ballet Fitness Surname Name Date of Birth Street PostCode City Emergency Informations Parent Surname & Name (required for children) Email Mobile Phone Physical Information Medical Conditions & Medication (please state all or N/D) Physical / Emotional Health (please state all or N/D) From time to time I may contact you about upcoming events and news concerning classes. If you would like to be included on this mail list, please advise. I give my permission for photos and videos which include images of me or my child to be used by Russian Ballet School for marketing and promotional purposes (including Internet and Social Media) By clicking I agree with therms and conditions listed below. I understand than Russian Ballet School will take all reasonable care to ensure that the classes are safe. However, I agree that me or my child will be engaging in physical activity, and as with all forms of exercise there is a small risk of injury occuring. I take full responsibility for any possible injury sustained by me or my child during class and agree to any sensible adjustments and assist with this. I have been advised to consult my or child's Doctor in order to ensure me or my child are able to attend classes and if me/he/she has any medical conditions that may affect my/his/her participation. I will inform Maria DUNHAM should there be any change in my child's medical conditions. Furthermore, alml classes are non-refundable unless Russian Ballet School cancels due to covering the hall hire. All information is strictly confidential and will be kept securely