Abingdon Dance Studios

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PUPILS QUESTIONNAIRE & INFORMATION SHEET

All new pupils need to complete the form below

Pupils questionnaire

Date submitted

Pupils Name

Address

Phone

Date of Birth

Emergency contact name and number

JUNIOR PUPILS ONLY - Parents name & Number

GDPR New data protection laws require us to obtain consent to store your personal information. We use this information to contact you about classes and events, to complete attendance registers, in case of emergency and to record payments made. We store this information securely and will delete it when you or your child no longer attends the dance school. Only Abingdon dance teachers will have access to this information. We only share your data with the IDTA and other dance schools if you take part in exams and competitions. Payment service providers that process information on our behalf. We will not share it with any other third party. You have the right to view or amend or delete the information we have on you. Please contact your teacher if you wish to do so. If you are happy for us to hold this information on you, please indicate by Opting -in below.

By checking, I give my consent.

Have you ever suffered from any of the following medical conditions? -------------------------------------- Diabetes

Yes

Stress or High Blood Presure

Yes

Asthma or Respiratory illness

Yes

Heart or Chest pain

Yes

Epilepsy, Fainting or Dizzy spells

Yes

Neck or Back injury

Yes

Hip injury

Yes

Knee injury

Yes

Any other Joint injury or condition

Yes

Allergies of any kind

Yes

Are taking any medication that may be effected by dance or exercise

Yes

Do you have any illness or injury that may be effected by dance or exercise

Yes

Any change to general health in the last 6 months

Yes

Is there any other information which may be relevant to your participation in dance or exercise

Yes

Are you pregnant or have you been pregnant in the last 6 months, if yes we recommend you do not participate in strenuous dance or exercise should you choose to do so it will be at you own risk.

Yes

If you have given birth within the last 6 weeks, or 8 weeks for a c-section, you will not be able to participate in dance or exercise for now.

If you answered Yes to any of the questions please provide further details here

Thank you for completing the New pupil form.

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Contact us

Call - 07590394306

Email-abingdondancestudios65@gmail.com

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