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EASTER CAMP APPLICATION 12th -16th April 2010

Rox School of Dance & Drama
Unit 3 Hove Business Centre
Fonthill Road
Hove BN3 6HA
Tel: 01273 208513
Email: sophierox@btconnect.com

  
*Student's Name:
*Sex: Male Female
Date Of Birth:
*Parent's Name:
*Email:
Telephone Number:
Emergency Contact / Mobile Number:
Medical Information / Special Needs:
*Address:
Have you previously attended ROX ?

Yes No

I enclose a deposit of *£37.50/£75 payable to: ‘ROX School of Dance and Drama’ and agree to pay the balance by 1st July 2008 *(If attending ½ day session please state am or pm)

 
 
 
 
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