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Engagement - Corali Form
The details on this form are for Corali’s use only, so that we can contact you about your session and keep you safe whilst you are with us.
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* Indicates required question
Name of dancer
*
Your answer
Date of birth of dancer
*
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/
DD
/
YYYY
Age of dancer
*
Your answer
Gender of dancer
Female
Male
Prefer not to say
Other:
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Name of person filling in this form (if guardian or carer)
Your answer
Email of person filling in form (if applicable)
Your answer
Emergency contact number
*
Your answer
Would you like to join Corali's mailing list so you can hear about other Corali events and opportunities?
Yes
No
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Please tell us why you want to apply for this class. For example, you could include information about your previous experience and interest in movement and performance.
Your answer
Do you self-identify as having a learning disability?
Yes
No
Prefer not to say
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Please use this space below to tell us about any access needs you may have?
Your answer
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