Student Name_____________________________________
Class Day________________ Class Time_______________
Date of Birth_____________________ Age_____________
Parent/Guardian name______________________________
Member/ (If applicable) Membership No___________
Address__________________________________________
_________________________________________________
_________________________________________________
Tel. Home__________________ Mob.__________________
Office______________________ Fax___________________
Email____________________________________________
Signature_________________________________________
Please complete form and hand in or send together with payment. Thankyou.
Cheques made payable to 'Red Shoe Dance Company Ltd'