FUNKY BEATS REGISTRATION FORM Funky Beats Registration Form Classes run Monday and Thursday evenings: Age Group(*) Tiny Toots – Monday 4.40-5pmJuniors – Monday 5.15-6pmOne to one Sessions – Monday 6.10-8.30pmSeniors – Thursday 5.00-6pmOne to one Sessions – Thursday 6.10-8.30pmFree taster on all group classes! Invalid Input Preferred Start Term(*) 7th September - 23rd October 20202nd November - 18th December 20204th January - 12th February 202122nd February - 26th March 202112th April - 28th May 20217th June - 20th July 2021 Invalid Input Parent/Guardian Details First Name(*) Invalid Input Second Name(*) Invalid Input Street Address(*) Invalid Input Street Address Line 2 Invalid Input Town(*) Invalid Input County(*) Invalid Input Post Code(*) Invalid Input Phone Number Invalid Input Mobile Phone(*) Invalid Input Email(*) Invalid Input Alternative contact details. (In case of emergency) First Name(*) Invalid Input Second Name(*) Invalid Input Relationship to Student Invalid Input Phone(*) Invalid Input Alternative Phone Invalid Input Student Details Students First Name(*) Invalid Input Students Last Name(*) Invalid Input Preferred Name Invalid Input Date Of Birth(*) Invalid Input Primary/Sibling(*) Primary StudentSibling Invalid Input If Sibling, please add the name of the Primary Student Sibling First Name Invalid Input Sibling Second Name Invalid Input Please give detailed information regarding any medical issues/disabilities that may affect the student's involvement. Medical Details Invalid Input Click here to read our safeguarding policy You have read our safeguarding policy(*) Yes Invalid Input Apply