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MBC Summer Intensive 2021
Application Form
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* Indicates required question
Email
*
Your email
Your Name
*
Your answer
Please enter your order number, this is shown on your booking confirmation email.
*
Your answer
Date booked
*
Choose
Monday 19 July
Tuesday 20 July
Date of birth
*
MM
/
DD
/
YYYY
Correspondence Address
*
Your answer
Student's Mobile Number
*
Your answer
Nationality
*
Your answer
Next of Kin Name and Relationship
*
Your answer
Phone Number of Next of Kin (this would only be used in an emergency)
*
Your answer
Current or past dance school and leavers year
*
Your answer
Please give details of any medical conditions or existing injuries we would need to know about?
Your answer
A copy of your responses will be emailed to the address you provided.
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