Registration Form | Wexli Academy

Registration

Parent's FULL Name

Parent Contact Email

Parent Contact Number

Parent Address

City

Postcode

Child's FULL Name

Child's Date of Birth

Child's Current School

Emergency contact 1 FULL name

Relationship to Child

Emergency Contact 1 Contact number

Emergency Contact 1 Contact number 2

Emergency contact 2 FULL name

Relationship to Child

Emergency Contact 2 Contact number

Emergency Contact 2 Contact number 2

Legalities

Legal Release & Policy Acceptance:

I have completed this form and provided a truthful declaration. I grant permission for my child to participate in sessions with this school and release Wexli Academy Ltd from any liability in case of accident/injury as I understand that Dance/Performing Arts is a physical activity – except those caused by negligence. I am fully aware of my child’s physical and mental status and I hereby find them fit to participate in this class. I agree to the terms and conditions set out in the privacy policy online at wexliacademy.com.

Your Signature

MEDIA CONSENT

I give permission to Wexli Academy to take photographs and video footage of my child. These photographs and videos may be reproduced and used for promoting or publicising Wexli Academy and may include printed or online publications (e.g. brochures, newsletters, website and social media). I give permission for my child to be in all forms of media, including print, online, broadcast (TV and Radio) in the UK and internationally.

I am aware that, for internet safety and data protections reasons, the full names of pupils will not be included on any online or printed material.

Your Signature

07912 548 965

Registration

Learning

WITHOUT LIMITS

wexliacademy@gmail.com