Register - Funkeynastix

Childs Details:

First name:

Surname:

Date of birth:

Gender

Boy Girl

Parent / Guardian Details:

Name:

Contact Mobile Number:

Email address

Please supply any extra information, such as allergies, disabilities, behaviours, that the instructors should be made aware of.

Photographic Permission:

From time to time we take photo and/or video of Funkeynastix classes in action. We would like your permission to use these photos and/or videos as material for Funkeynastix social media specifically We will never reference your child by name or provide any specific information.

Please select:

Yes I give you permission No I do not give you permission

We would like to keep you informed from time to time of Funkeynastix Activities, such as Holiday Camps. If you would like to recieve this information, please selecets.

Please select:

YES NO

Acknowledgment:

I have read, understood and will abide by the terms and conditions detailed.

Yes