Student Name*

Date of Birth*

School

Year Group

Guardian Name (If student is under 18)

Address*

Telephone*

Email*

We require information about any medical conditions or allergies the dancer named above may have to inform staff and ensure the safety of our students. Please leave blank if this does not apply.
Medical Conditions or Allergies

Emergency Contact Name*

Emergency Contact Number*

By checking this box you agree to the dancer named above being involved in documenting RYDA rehearsals and performances by photo or video. This material may be used in future marketing.
I agree

I confirm that the information provided above is correct. I will inform RYDA as soon as possible if any of these details change.
I confirm

*Required Field