Parental Consent Form

Parent/Carers Details:

Child's Details:

Does your child have any health issues, special needs, or allergies that we should be aware of?

Is your child authorised to make their way home by themselves?

Names of people authorised to collect your child. Please provide their full name, relation to you and a contact number. (This includes lift sharing, friends, taxis, babysitters, private drivers, etc.)

Please confirm that you have read and agree to the following:

I give permission for the child named above to participate in Mini Professionals Dance Academy classes run by Principal Bethany Gorton and associated teachers. I realise that participation in this activity involves risk of injury. I hereby waive and release Bethany Gorton and all teachers, instructors, volunteers and employees from any and against all claims of liability including accidents, injury or death.

I, the undersigned, hereby grant permission to Bethany Gorton and Mini Professionals dance teachers to photograph and/or record on video and to use this material in whole or in part, to promote Mini Professionals Dance Academy. I understand that the material will remain property of Bethany Gorton and associated teachers. I further waive any claim to remuneration for material used for these purposes.

Where did you hear about Mini Professionals Dance Academy?

If Other - Please State Where.

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