Student Name *FirstLastStudent AgeContact Number (Mobile or Other)Email *AddressApplication For *Oranges (ages 3 to 7)Greens (ages 8 to 11)Blues (ages 13 and up)Mental and/or Medical ConditionsEmergency contact person and mobileOther CommentsFilming and photography *I authorize Mandy Dance Academy to film and photograph my daughter whereby images can be used on media for advertising and display purposes in relation to the academy.Data Protection *I authorize Mandy Dance Academy to keep record of my information and only share it in case of emergencies.PhoneSubmit General Application Form
