UpTop Dance Kilburn – Dance trial registration form

Charteris Sports Centre, 24-30 Charteris Rd, London NW6 7ET

This form is designed for registering for a free trial. We’ll utilize the provided information to schedule your complimentary dance trial. Should you choose to continue dancing with us beyond the trial, your details will be integrated into our student database. UpTop Dance School maintains the utmost privacy and does not share your information with any third parties.

Parent/Guardian Information

Parent First Name

Parent Second Name

Parent phone number

Student information

Student First Name

Student Second Name

Student date of birth

Does your child suffer from any medical conditions that we should be aware of?

Student Age Group

Desirable trial day : Please choose from the available classes

Thursday , 17:00-17:45 MINI (ages 4-5)

Wednesday, 18:00–19:00 KIDS (ages 6-9)Saturday, 13:00–14:00 KIDS (ages 6-9)

Thursday , 18:00–19:00 JUNIORS (ages 10-14)Saturday , 14:00-15:00 JUNIORS (ages 10-14)

Agreements

I agree with the UpTop Dance Terms and Conditions Read UpTop Dance Terms and Conditions

During our dance classes and performances, we will be taking photos and videos that we may use for educational or marketing purposes. By attending our classes you agree for your child to be featured in our media. UptopDance commits to not using such media in any way that might be harmful towards our students.

Upon receiving trial date confirmation from UpTop Dance, I agree to attend the chosen free trial. I understand that not doing so could potentially prevent another child from participating due to limited capacity.