CONTACT FORM (for members only) | knowlesdancefitness

Dance fitness Norwich

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Please complete this form if you are a member at Knowles Studios.

Knowles Emergency Contact Form

CHILD'S FULL NAME

PARENT/GUARDIAN'S NAME

CHILD'S DATE OF BIRTH

CONTACT NUMBER

EMAIL ADDRESS

SECOND CONTACT NAME

SECOND CONTACT NUMBER

PHOTO & VIDEO CONSENT Please tick YES if you are happy for us to take photos and videos for our social media pages and website which may include your child. Please tick NO if you would prefer not to have photos or videos shown.

YES

NO

Please let us know if your child has any medical conditions, allergies or take any medication we will need to know about :

Due to the General Data Protection Regulation (GDPR), we need your permission to contact you. If you are happy to be contacted from us with updates and news about the studios please submit YES.

YES

NO

Your Signature

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