Registration or update of student details

You can use this form to submit details of a student or students to our database.
You can also use it to update information we already hold if it has changed

Once you have completed the form click the Send Details Button.

Please complete a new form for each student you wish to register.
To begin a new form please press the reset button to clear any previous data after you have sent it.

By clicking the Send Details Button, you will automatically send a copy of the information
you entered to The Lakeland Studio of Dance and Performing Arts.

To enable this form to be sent you must enter a valid Email address in the Email box.

Need help? Click here to send an Email to Stuart Warren who looks after the administration of student details.

Please type the details in the boxes below

Is this the first time you are submitting details

or are you updating existing information due

to something like an address change?

First Registration

Update of Existing Details

Student Name:
Address Line 1:
Address Line 2
Address Line 3
Town:
County:
Post Code:
Email:

Date of Birth:

Day:

Month:

Year:

Telephone

Home:
Other:		Comment eg "work":

Examinations Taken in Dance, Drama and Music:
(Please state Examination Board)

Are there any Medical Conditions we should be aware of?:

Any Other Comment - for example emergency contact
details if not covered by the information above:

Please indicate, by clicking in the boxes below, the type of class or classes most likely to be taken.

Baby Dance
Childrens' Ballet
ISTD Modern
ISTD Tap
Funky Modern Jazz
Adult Dance
Adult Beginner Class
Adult Funky Jazz
Salsa
Stretch/Jazz
Private Lessons

Finally please supply the name of a
Parent or Guardian if relevant:
(Please state relationship to student)

Please complete a new form for each student you wish to register.
To begin a new form please press the reset button to clear any previous data after you have sent it.