Registration - Inspirations

Username^*

Email^*

Student’s First Name^*

Surname^*

Student’s D.O.B^*

(Sibling) Student’s Name - if applicable

Student’s D.O.B

(Sibling) Student’s Name - if applicable

Student’s D.O.B

Parent / Guardian 1: (Name & Relation to Child)^*

Contact Number:^*

Parent / Guardian 2: (Name & Relation to Child)^*

Contact Number:^*

Medical Form

Does your child have Asthma?
Does your child have any Allergies or Skin Conditions?
Does your child have a Hearing or Visual Impairment?
Does your child have any learning disability?
Do they take any regular medication(s) ?
Does your child have any medical conditions such as elevated blood cholesterol, diabetes, epilepsy, sustained illness / high or low blood pressure ?
Does your child ever experience dizziness or fainting and/or chest pains brought on by physical activity?
Does your child have any bone, joint or muscular problems / injuries ?

Emergency Contact: (Name & Relation to Child)^*

Contact Number:^*

Photo Permission - for marketing purposes for Inspirations School of Performing Arts - website, printed and promotional material and social media.^*

If you have answered yes to any of the above medical questions then please let us know any further information we should know. Additionally if your child has a medical condition not mentioned above then please let us know below.

Covid 19 Procedures & Guidelines^*

In the event of a lockdown / Government restrictions, classes will take place live online on Zoom
Inspirations School of Performing Arts / Inspirations does not accept liability for any cases of Covid-19. All necessary precautions will be taken.