8-10 Years One Day Ballet Intensive Application Form

Applicant's Details
First name*
Surname*
Is the applicant a current Junior School student at Central School of Ballet?*
- Yes
- No
Which class(es) does the applicant attend?*
Address*
Post Code*
If you live in London, please specify in which borough
If you are a Southwark resident and would like to receive the 20% Southwark discount, please tick this box.
Please note, by ticking this box you are confirming that your permanent place of residence is within Southwark. You will be asked to present proof of address when arriving at Central School of Ballet and before the attending student checks into the course.
If your application to the course is accepted, you will receive an email containing a coupon code in order to access the Southwark discount.
- I am a Southwark resident and would like to receive the 20% discount
Date of Birth*
DD dash MM dash YYYY
Age*
Please enter a number from 8 to 10.
Current School Year*
Gender*
Please specify*

Parent / Carer Details
First Name*
Surname*
Email address for all correspondence*
Telephone*

Emergency contact details for the duration of the course
Name*
Relationship to the applicant*
Contact Telephone Number*
(Please provide a mobile telephone number if possible.)

Education Details
Education*
Name of school or college
Address
Post Code

Dance Training
Dance School(s)*
Name of Dance School Address Dates Attended Hours of Training Per Week
Please tell us if the applicant has studied any of the dance genres below
- Ballet
- Pointe
- Modern
- Tap
- Contemporary
- Jazz
- Street
- Hip-hop
- Ballroom
- South Asian
- Other
Please specify
Please provide details of the applicant's most recent examinations and results achieved or the current level the applicant is working at*
Is the applicant considering applying for pre-vocational training?*
- Yes
- No
- Unsure/not decided
Is the applicant considering applying for full time dance training?*
- Yes
- No
- Unsure/not decided
Has the applicant previously attended any Central School of Ballet courses or auditions?*
- Yes
- No
If yes, please specify which courses/auditions*
How did you hear about this course?*
Please specify*

Injuries & Medical Conditions
Please specify any ongoing medical conditions, allergies and recent injuries and relevant treatment.
Disclaimer*
- I understand that the information I provide on injuries and medical conditions will be processed by appropriate individuals only in accordance with access protocols (i.e. on a ‘need to know’ basis). I can withdraw my consent at any time by emailing participation@csbschool.co.uk

Photography Permission
Central School of Ballet may take photographs and/or film footage in classes which will be used at the discretion of Central School of Ballet and partner organisations on social media and future marketing campaigns. To comply with the General Data Protection Regulation (GDPR) and the Data Protection Act 2018, we need your permission before any images of the applicant (aged under 18) are taken. Please note, names of children will not be printed alongside photographs.
Please select one of the following*
- YES, I give permission for the applicant to be photographed and/or filmed during classes, and for the resulting images to be used by Central School of Ballet and partner organisations.
- NO, I do not give permission for the applicant to be photographed and/or filmed during classes, and for the resulting images to be used by Central School of Ballet and partner organisations.

Marketing Preference
Mailing List
- I would like to hear more about Central School of Ballet and Ballet Central, including news, fundraising, forthcoming events and wider opportunities.
By ticking the above box, you are consenting to sign up to our MailChimp newsletter with the email you provided earlier on this form. Please note that you must be aged 18 or over to receive emails from Central School of Ballet.
Please provide the email address where you would like to receive these updates*
Long-term evaluation
Central School of Ballet may wish to contact you to assess the long-term impact of our work. Do you consent to being contacted?*
- Yes
- No
Declarations
*
- Please tick this box to say you have read and agreed to the Privacy Policy here
*
- I certify that to the best of my knowledge the information provided in this document is accurate at the time of writing. I accept that any amendment to the information provided after acceptance and acknowledgement of this application could result in the loss of a place. I have also read and understand the Payment and Refund Policy detailed here
*
- I confirm I give my explicit consent for the information I have provided in this form, including any information on injuries and medical conditions, to be processed by appropriate individuals only in accordance with access protocols. I can withdraw my consent at any time by emailing participation@csbschool.co.uk
Once you click submit, you will receive an email confirming that we have received your application. If you do not see this confirmation in your emails, please check your junk/spam folder for an email from Central School of Ballet.
Parent / Carer Signature*

8-10 Years One Day Ballet Intensive Application Form

Step 1 of 9 – Applicant’s Details

Applicant's Details

Parent / Carer Details

Emergency contact details for the duration of the course

Education Details

Dance Training

Injuries & Medical Conditions

Photography Permission

Equality and Diversity Information

Marketing Preference

Long-term evaluation

Declarations

Name of Dance School	Address	Dates Attended	Hours of Training Per Week