Details of parent(s)/carer(s) Parent/carer 1: Name* Email* I agree to being contacted by email Daytime contact number* Relationship to student* Parent/carer 2: Name* Email* I agree to being contacted by email Daytime contact number* Relationship to student* Additional emergency contacts - adults who can collect your child in case of illness/emergency if you are not available Emergency contact 1: Name* Daytime telephone* Mobile* Relationship to student* Emergency contact 2: Name* Daytime telephone* Mobile* Relationship to student* Student details (click "+" button to add more students with the same contact details above) Student contact details Full name* Date of birth* malefemale Home telephone Mobile Email I agree to being contacted by email Home address* Postcode* Medical details Does the student suffer from any allergies or require any special medical attention? yesno If Yes, please specific allergy Medication (if required) Name of Doctor* Telephone* Surgery address* Postcode* I consent to basic first aid being administered to the student by The Direct Dance Company if required. I give permission for The Direct Dance Company to take appropriate action to obtain medical help for the student, including sending them to hospital if required. I give permission for The Direct Dance Company to authorise medical treatment for the student should it be required on their admission to hospital, if we are unable to contact you. I give permission for The Direct Dance Company to use images and/or moving images of the student for marketing/advertising/website/social media and training aids. If you do not wish images or footage of your child to be used by The Direct Dance Compnay, we will respect your wishes. -+ Agreement text... Parent/carer signature* Name* Date* Declaration text... Parent/carer signature* Name* Date* Details of parent(s)/carer(s) Parent/carer 1: Name* Email* I agree to being contacted by email Daytime contact number* Relationship to student* Parent/carer 2: Name* Email* I agree to being contacted by email Daytime contact number* Relationship to student* Additional emergency contacts - adults who can collect your child in case of illness/emergency if you are not available Emergency contact 1: Name* Daytime telephone* Mobile* Relationship to student* Emergency contact 2: Name* Daytime telephone* Mobile* Relationship to student* Student details (click "+" button to add more students with the same contact details above) Student contact details Full name* Date of birth* malefemale Home telephone Mobile Email I agree to being contacted by email Home address* Postcode* Medical details Does the student suffer from any allergies or require any special medical attention? yesno If Yes, please specific allergy Medication (if required) Name of Doctor* Telephone* Surgery address* Postcode* I consent to basic first aid being administered to the student by The Direct Dance Company if required. I give permission for The Direct Dance Company to take appropriate action to obtain medical help for the student, including sending them to hospital if required. I give permission for The Direct Dance Company to authorise medical treatment for the student should it be required on their admission to hospital, if we are unable to contact you. I give permission for The Direct Dance Company to use images and/or moving images of the student for marketing/advertising/website/social media and training aids. If you do not wish images or footage of your child to be used by The Direct Dance Compnay, we will respect your wishes. -+ Agreement text... Parent/carer signature* Name* Date* Declaration text... Parent/carer signature* Name* Date*