aj dance - registration form

This form is for those who have confirmed a place in our classes and booked a date to start.
Please only fill in this form if you have been asked to do so prior to attending your 1st class.

Student details


Parent / guardian details


Additional information

medical declaration

declaration & disclaimer

I being  the legal Parent/ legal Guardian of the above named student, declare that that the information given in this application is correct and hereby apply for a place for my child at AJ Dance Productions.


Activities of this nature carry an element of risk and I understand that AJ Dance Productions / Pulse Performing Arts accepts no liability for any physical injuries arising from my child taking part in such activities.

I give permission for photographs to be taken of my child for the

purpose of promotion and publicity for AJ Dance Productions / Pulse Performing Arts. (If you do not wish you're child to be included in any photography please mention this upon arrival).


I have read and understand the terms and conditions of AJ Dance Productions / Pulse Performing Arts and agree to abide by them.

I agree in order to teach dance effectively it is sometimes necessary to demonstrate using physical contact to clarify verbal instruction.

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