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Sibylle Kockjeu
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Dancer's Details
Dancer First Name
*
Dancer Last Name
*
Birthday
*
Day
Month
Month
Year
Age
*
Phone (of parent if under 18)
*
Email (of parent if under 18)
*
Current dance school
*
Dance experience (what styles and how many years)
*
Any medical conditions or injuries we need to be aware of
*
No
Yes
If YES - please provide additional information
Please confirm your acceptance that images and videos taken during the Dance Classes may be posted on social media
*
Yes, I give consent
No - no photos or videos please
Parent's Details
Parent First Name (if under 18)
Parent Last Name (if under 18)
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