VBDance Presents 'Debut'

Parent/Guardian Name*

First Last

Parent/Guardian Home Telephone Number*

Parent/Guardian Mobile Number*

Parent/Guardian Email Address*

Emergency Contact Name*

First Last

Please provide the name of an alternative emergency contact in the event we are unable to contact you.

Alternative Emergency Mobile Telephone Number*

Performer 1 Name*

First Last

Current School Year

Performer 1 Date of Birth

Performer 2 Name (if applicable)

First Last

Current School Year

Performer 2 Date of Birth

Performer 3 Name (if applicable)

First Last

Current School Year

Performer 3 Date of Birth

Please state below any medical conditions or other issues we should be aware of for all of the performers listed above.

What is your child's current leotard size? (Please check label inside leotard)*

If you have more than one child performing, please select on this form.

Please indicate an approximate clothing size for your child*

If you have more than one child performing please select all relevant sizes.

Photography and Video Consent

Permission is given for use of photography and film of my child/children to be used for marketing purposes both online and in print. (Names will not be published).

Consent - I understand & agree to the following conditions for my child/children to participate in the show.

I understand & agree that my child must attend all classes during the Summer term unless due to extenuating circumstances which the teachers have been notified of in advance via email.
I understand & agree that my child must attend Sunday 12th July (daytime) at Burgess Hill Girls (8:30am - 1pm).
I consent to my child/children's full name being printed and published in the show programme
I understand & agree to pay the costume hire and production fee and am aware that this will be collected via Go Cardless (an invoice will be emailed in advance).

VBDance Presents ‘Debut’