LSS Children's drumming and dance workshops 2018

London School of Samba

Children's drumming and dance workshops 3.30 - 4.30 pm 11th March 2018 - Waterloo Action Centre 14 Baylis Road London SE1 7AA
London School of Samba Children's drumming and dance workshops registration and payment form
1st Child price - £5 *

First Name Last Name
Age *
*

Male Female
Additional child - £3 per child

age + gender Name
Additional child - £3 per child

age + gender Name
Additional child - £3 per child

age + gender Name
Additional child - £3 per child

age + gender Name
Parent/guardian's name *

First Name Last Name
E-mail *
I being the parent/guardian of the child/children named above give permission for them to take part in this class *

yes
We will be filming the class and taking photos for promotional purposes if you would prefer your child's image not to be included please indicate here *

Yes I am happy for my child / children to be filmed and their photograph to be used No I do not want my child / children to be filmed or photographed
Are there any health issues or disabilities that we should be aware of. If so please give details
The following information is used for monitoring purposes only
From the drop down form please choose a description that best describes your child's ethnic origin
Please pay by PayPal

Drumming and Dance workshop 1st Child £ 5.00 GBP

Drumming and dance workshop additional children each - £ 3.00 GBP

Quantity

Total £ 0.00 GBP
Any queries please contact Liz - lssfinance.lss@gmail.com
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London School of Samba