* required fields

Member's Name *

Parent's Email Address *

Home Phone Number

Your Address & Postcode

Parent's Emergency Mobile

Member's Mobile Number

Member's email address

Member's Date of Birth

Any medical information we should have.
(please tell us about diabetes / epilepsy / asthma
/ dyslexia / dyspraxia / aspergers / autism)

Date you will start to come to Spotlites

Which session do you wish to join.
Please select location, then the session.
Please only select one

Chatham (Spotlites Theatre)

Maidstone on Tuesdays (@ Brunswick House)

Sittingbourne on Saturdays (@ New House Centre)

Can we & the press take photos and video of your child
to be used on our website or their newspaper / website

I give permission for my child / self (if over 18 years)
to take part in Spotlites Workshops.
I accept that whilst every care will be taken
this will be at my own risk.

I have read and accept Spotlites dance rules
(click to read the 'Spotlites dance rules')
and agree that after having attended for 5
or more weeks to give 4 weeks term time
week's notice or pay 4 weeks term fees
in lieu to stop my membership when the time comes.

Should the necessity arise, I give permission
for an anaesthetic to be administered
to my child (self if over 18 years)
or for any other urgent medical treatment to be given.

I give permission for these details
to be kept on Spotlites' computer database
to aid emergency contact.
(We do not share or sell any of our Data to anyone else)

I give permission for my name and email address
to be kept on Spotlites' computer database
and allow Spotlites to send me information regarding
upcoming events and shows that Spotlites hold.
You can unsubscribe at anytime using the unsubscribe
feature at the bottom of every email we send.
(We do not share or sell any of our Data to anyone else)

Parent's Signature (print name)

Name of Parent/Guardian who completed this form

Please click SUBMIT below,
you will then be redirected to the payment page

We do not share or sell any of our Data to anyone else.