Open Classes Registration Form

Full Name

First Name

Last Name

Address

City

State/Province

Zip/Postal

Country

Email

Phone

Next of Kin name, email address and telephone number

A single class is worth £20.00, and your first class has no obligation to continue. If you choose not to use your bundle to take further classes after your first class, you will not be charged.

Would you like to pay for the bundle in monthly instalments?

Yes

No

1. What is your reason for taking Dalcroze Open Classes?

2. These classes use low-impact whole body movement, including walking, running, skipping, jumping, swinging, using balls, and other materials. Do you have a health condition that would require some exercises to be modified for you (for example, dizziness, back, or foot conditions)

3. Would you like to be added to our mailing list and keep up to date with our activities, news, and events?

Please indicate which date you will be attending for your free taster class. You may participate in any of the available dates shown in the table on the webpage, until the number of classes in your bundle has been used.

An information pack will be sent to you by email after you submit this registration form.