Workshop/Class registration
Please complete this registration form to sign up to take part in any of our Community Programme classes - Live Well and Dance with Parkinson's, Creative Movement, or Blue Mind Meditative Movement.
We will then send you an email with booking information for individual sessions.

If you have any difficulties completing the form, or any other questions, send us an email at theatrepelican@gmail.com
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Name *
Email *
Date of Birth *
MM
/
DD
/
YYYY
What classes are you interested in taking part in? *
Required
Do you have any access requirements you'd like us to know about? Please describe here. *
Name of Emergency Contact *
Phone Number for Emergency Contact *
Are you happy to be filmed/photographed for marketing purposes? *
Is there anything else we should know? *
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