040716 Office use only:

Chq/Cash……………..

Date……………………..

MARIAN VIAN PRIMARY SCHOOL

ALL DANCE CLASSES START STRAIGHT AFTER SCHOOL AND FINISH AT 4.15 p.m.

CLASSES RANGE FROM Street Dance, Freestyle, Jazz, songs from Musicals and ‘themed’ dances.

BOTH BOYS AND GIRLS ARE WELCOME!

TERM / DAY / TERM DATES / TOTAL / Inset / Bank Hols
AUTUMN 1 / Tuesday – Infants
Wednesday – Juniors / 13 Sep - 18 Oct 2016
14 Sep - 19 Oct 2016 / Total £ 27.00
Total £ 27.00
AUTUMN 2 / Tuesday – Infants
Wednesday – Juniors / 1 Nov - 13 Dec 2016
2 Nov - 14 Dec 2016 / Total £ 31.50
Total £ 27.00 / Parents Eve – 16 Nov
SPRING 1 / Tuesday – Infants
Wednesday – Juniors / 10 Jan - 7 Feb 2017
11 Jan - 8 Feb 2017 / Total £ 22.50
Total £ 22.50
SPRING 2
/ Tuesday – Infants
Wednesday – Juniors / 21 Feb - 28 Mar 2017
22 Feb - 29 Mar 2017 / Total £ 27.00
Total £ 22.50 / Parents Eve – 22 Mar
SUMMER 1
/ Tuesday – Infants
Wednesday – Juniors / 18 Apr - 23 May 2017
19 Apr - 24 May 2017 / Total £ 27.00
Total £ 27.00
SUMMER 2 / Tuesday – Infants
Wednesday – Juniors / 6 Jun - 11 Jul 2017
7 Jun - 12 Jul 2017 / Total £ 27.00
Total £ 27.00

TERM: ………………………………………………………………………………………………………………..

NAME OF CHILD: ......

YEAR & CLASS: (FROM SEP 16) …………………………………………………………………………………………………………………

DATE OF BIRTH: ………………………………………………………………………………………......

PARENT/GUARDIAN’S NAME: ………………………………………………………………………......

EMERGENCY CONTACT NO: Home: ……………………………………… Mobile: …………………………………………..

MEDICAL CONDITION(S): ………………………………………………………………………………………………………………..

NAME OF PERSON(S) RESPONSIBLE FOR COLLECTING YOUR CHILD AND THEIR CONTACT NUMBER:

Name: ………………………………………………………… Tel No: …………………………………….…………… Relationship: ………………………………………….

Name: ………………………………………………………… Tel No: ……………………………….………………… Relationship: ………………………………………….

Please return this form with your payment to Bev/Laura or to the school office

before the start of each half-term to secure your child’s place.

Payment can be made by cash or cheque (payable to Danzefuzion)

or transferred to Account: 41767074, Sort code: 09-06-66, Account name: Danzefuzion.

Please put your child’s name and school as a reference and send us a text to confirm your payment.

Late collection will result in additional charges of £1 for every 5 minutes, after an initial 5 minutes.

FOR FURTHER INFORMATION PLEASE CONTACT BEV (07838 473041) OR LAURA (07977 630848)

Booking Forms can also be downloaded from our website www.danzefuzion.co.uk