Dance Buckingham - Registration Form

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Dance Buckingham - Registration Form

Please ensure you fill out the following details for each dancer

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* Indicates required question

Email *

Your email

Title

Mr

Miss/Mrs

Other:

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Full Name *

Your answer

Phone Number *

Your answer

Are there any medical conditions that could effect you participating in physical activities such as dance or exercise? *

Yes

No

If yes please provide details you are prepared to share with us to ensure your safety.

Your answer

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