Please complete the following forms to register your child’s place at one of our After School Clubs. All information is kept private and confidential.
Child’s Full Name *
Child’s School Year * Year 1Year 2Year 3Year 4Year 5Year 6
Autumn Term 2019
Bolnore Village Primary School
St Wilfrid‘s C Of E Primary School Haywards Heath
Northlands Wood Primary Academy
Wivelsfield Primary School
School * Bolnore Village Primary SchoolSt Wilfrid‘s C Of E Primary School Haywards HeathNorthlands Wood Primary AcademyWivelsfield Primary School
Mobile Phone Number *
Email Address *
Does Your Child Have Any Medical Conditions? If Yes Please Explain
Does Your Child Suffer From Any Allergies? E.g Food, Medication, Plasters etc
Does Your Child Require Any Prescribed Medication During Classes?
I agree for Bpm Dance Academy to use the information you provide on this form to be in touch with you and to provide updates and marketing.
Full Name *
Date *
5 + 3 = ? Please prove that you are human by solving the equation *
