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Academy Of Movement
1A Boldero Road, Bury St Edmunds, IP32 7BS
info@academyofmovement.co.uk
07934954741
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Circus Soft Play
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Please complete the below form by: 31/03/23
Show Permission Form
To be filled out by parent (one form for each child)
Childs Details:
Childs First Name
Childs Last Name
Date of birth
Email
EMERGENCY CONTACT DETAILS:
Contact First Name
Contact Last Name
Contact Phone Number
Any Medical infomation that you feel is appropriate
I confirm that my child is fit and well enough to take part in this years show and dress rehersal
Childs Dress / Costume Size (Please size up if in between sizes)
Choose an option
I agree to my child being photographed. I am aware that this may be used for promotional purposes
Choose an option
I agree to my child being filmed for the show DVD. I am aware that this may be used for promotional purposes.
Choose an option
I give permission for my childs name to appear in the show programme and end credits of the DVD
Choose an option
By ticking this box I confirm that it is a commitment to BOTH the show date (Saturday 15th July) AND the dress rehersal (Sunday 9th July)
I understand and accept that the show fee is non-refundable
Your Signature
Clear
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