ATTITUDE DANCE CONSENT FORM

RISK: Dance is naturally strenuous activity. I understand that whilst every care will be taken by workers, that they cannot be held responsible for any accident that may arise. I am aware that some activities carry a risk and realise that this controlled risk is an important part of the educational experience. (Staff treat the safety of your child and that of others as paramount to any other consideration).

COVID19 PRECAUTIONS: Due to current regulations on social distancing, “spotting” or assisting a skill is not advised. If a child needs help on a toilet visit or first aid, then a member of Attitude staff will put on appropriate PPE to assist. Please inform us on this document if this is not agreeable.

ANY CHILD THAT IS SHOWING COVID19 SYMPTOMS, OR LIVES WITH SOMEONE WHO IS, SHOULD REMAIN AT HOME AND NOT ATTEND SESSIONS UNDER ANY CIRCUMSTANCES. ANY POSITIVE COVID19 TEST SHOULD BE SHARED WITH US, SO THAT WE CAN FOLLOW APPROPRIATE TRACK AND TRACE GUIDANCE.

As part of our guidance, we have allocated a quarantine area and any child who develops symptoms at class will be moved to this area and parents contacted immediately. Your support would be appreciated by ensuring that your child is collected as quickly as possible.

Payment: Classes are £5.00 a week, payable half term in advance and are due the first class back each half-term. Fees are not refundable for missed classes.

This form enrolls the young person in the Attitude dance class named above for up to one year, all information is treated as strictly confidential.

Name of class *

Tutor *

Day of session *

Time of session *

Name *

First

Last

Address *

Postcode *

Home telephone number *

Primary emergency contact name *

Primary emergency contact number *

Secondary emergency contact name *

Secondary emergency contact number *

Email address *

Medical information *

Does your child/ward suffer from any conditions requiring medical treatment? If yes please give brief details. Please can any inhalers or epi-pens be brought to class. If appropriate, please sign for permission to administer epi-pens.

Any allergies? *

Permissions *

I hereby give persmission for Attitude Dance Leeds to use my child's image in promotional material i.e. Show programmes/flyers/website/facebook
I give permission for Attitude Dance Leeds to keep registration forms in a locked storage cupboard
I give permission for Attitude Dance Leeds to keep contact number stored on their mobile phone
I give permission for my email address to be stored on Attitude Dance Leeds' invoicing system
I give permission for Attitude Dance Leeds to share necessary details with associated bodies for performances/competitions/examinations
I agreee to let Attitude Dance Leeds to contact me via - Phone, email & text

Child collection information

Who will be collecting your child from sessions? We are not able to allow your child to go home with anyone who is not names here, unless prior notification has been given. If your child is to walk home alone - please give details here.

DECLARATION: FULL NAME: *

First

Last

I will inform Attitude Dance of any changes to the information provided on this form.

Relationship to child *

I acknowledge and agree to the following: *

The risk, Covid19 precautions and fees

As explained at the top of the page.

ATTITUDE DANCE CONSENT FORM

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