Registration Please complete the form below. Student Registration Please complete the form below to register yourself or your son/daughter with Mad2Perform. Please enable JavaScript in your browser to complete this form.Class of interest *Full name of child *FirstLastChild's date of birth *Child's home address including postcode *Parents/guardian name *Emergency contact numbers(s) *Parents/guardians email address *Medical info: Does your child suffer from any medical, physical, emotional or behavioural conditions that might affect their safety at any point? (If yes please specify) *If your child is currently undergoing any form of medical or psychological treatment, including medication? (If yes please specify) *Does your child have access requirements? e.g visual timetables, sensory breaks, step free access etc. Consensual info: How will child get home after session(s)? *On their ownParent/GuardianOther (please state)Please state:Do you agree for your child to have their photograph (including video) taken by MAD2PERFORM’s creative leaders in class and events? *YesNoDo you agree for your child to have their photograph (including video) taken by a DBS checked photographer at MAD2PERFORM’s shows? *YesNoDo you agree to have your child’s photograph (including video) shared on Mad2Perform social media sites? *YesNoDo you agree to have your child’s photograph published on marketing materials such as posters, flyers etc.? *YesNoI, the parent/guardian of child listed above herby sign this disclaimer. I acknowledge liability and release from any and all liability of injuries, loss or damage to personal property that may arise in any event of mine or my child’s participation in MAD2PERFORM’s activities at any class/event. I agree to all the permissions that have been ticked above. I agree to comply with all the rules and regulations set my MAD2PERFORM’s creative leaders as well as safety provisions. I agree to my child to take part in Mad2Perform’s sessions. I acknowledge the need of responsible behaviour and obedience on their part. I agree to the company MAD2PERFORM payment terms and conditions. *Signature *Date *Submit