AMPLIFY AMPLIFY AMPLIFY SIGN UP FOR AMPLIFYWE ARE GIANTS Name * First Name Last Name Phone * (###) ### #### Email * Age & Date of Birth * Emergency Contact Name * Emergancy Contact Number * Emergency Contact Email * Home Address & postcode * MEDICAL: Any allergies? Health Concerns? Medications? Injuries? * ACCESS: any special accommodations? * CONSENT: I acknowledge the understanding of any risks associated with dance classes and acknowledge personal responsibility in case of injury * Yes No PHOTOGRAPHY: Do you give permission to being photographed or filmed during class or performances? * Yes No Which rehearsal and demo days will you be attending? * Sunday 16th March - 10:00 AM-4:00 PM (Southpaw Studio) Tuesday 18th March – 1:00PM-6:00PM (Keel Square) Wednesday 19th March – 11:00AM-5:30PM (Keel Square) Thursday 20th March – 11:00AM-5:30PM (Keel Square) Thank you! See you at We Are Giants rehearsals!
