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Choose day (please fill out ALL fields below)

Monday Juniors
Tuesday Infants
Tuesday Seniors
Wednesday Infants
Wednesday Seniors
Thursday Infants
Thursday Seniors
Friday Juniors

First Name

Surname

Date of Birth

Day

Month

Year

School year and name of school

Other school (please type "none" if you have filled in previous field)

House name or number

Address

Address (please type "none" if you don't have another line of address)

Town and postcode

Home telephone

Mobile

Emergency number

Doctor

Doctor Telephone

Allergies if known (please type "none" if your child has none)

Permission for Photography with promotional work in connection with Beginners On Stage and also to appear on the Beginners On Stage website

Permission for Photography

Yes
No

This information is strictly confidential and will NEVER be given to a third party. All information is held on file for the duration of your child's association withBeginners On Stage.

Parent Guardian Name

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