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BOOK YOUR FREE TRIAL HERE
Students First Name:
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Students Last Name:
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Students D.O.B:
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Contact Email Address:
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Mobile Number:
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Address:
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Emergency Contact Person Details
(THIS DATA WILL ONLY BE USED IN EMERGENCY)
PLEASE INCLUDE: Name of person, relationship to you and their mobile number
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Medical conditions (please type 'NONE' if none):
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How did you hear about Hip Hop Pop?:
Facebook
Google
Word of Mouth
At a Performance
Through a School
Other
Which class would you like to try?
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Mondays 4.10pm 30 mins Age 3-5 All Levels (Harlow)
Mondays 4.45pm 45 mins Age 6 to 9 All Levels (Harlow)
Mondays 5.30pm 45 mins Age 10 to 11 All Levels (Harlow)
Mondays 6.15pm 45 mins Age 11 to 16 All Levels (Harlow)
Mondays 7.00pm 45 mins Age 14 to 18 Int / Adv (APPLICATION/INVITATION ONLY CLASS) (Harlow)
Mondays 7.45pm 1hr 15 mins Adult (age 16+) Advanced (CURRENTLY FULL & APPLICATION/INVITATION ONLY CLASS) (Harlow)
Tuesdays 4pm 45 mins Age 6 to 9 All Levels (Harlow)
Tuesdays 4.45pm 30 mins Age 3 to 4 All Levels (Harlow)
Tuesdays 5.20pm 30 mins Age 4 to 5 All Levels (Harlow)
Tuesdays 6.00pm 45 mins Age 6 to 9 All Levels (Harlow)
Tuesdays 6.45pm 45 mins Age 10 to 11 All Levels (CURRENTLY FULL – JOIN WAITING LIST) (Harlow)
Tuesdays 7.30pm 45 min Age 11-16 All Levels (Harlow)
Thursdays 5.15pm 30 mins Age 3 to 5 All Levels (Stortford)
Thursdays 5.45pm 45 mins Age 6 to 9 All Levels (Stortford)
Thursdays 6.30pm 45 mins Age 10 to 11 All Levels (Stortford)
Thursdays 7.15pm 45 mins Age 11 to 16 All Levels (Stortford)
Thursdays 8.30pm 1 hour Adult (age 16+) Intermediate (Sawbo)
Saturdays 9am 30 mins Age 3-5 All Levels (Harlow)
Saturdays 9.40am 30 mins Age 3 to 5 All Levels (Harlow)
Saturdays 10.15am 45 mins Age 6 to 9 All Levels (Harlow)
Saturdays 11am 45 min Age 10 to 11 All Levels (Harlow)
What date would you like to come for a FREE TRIAL?:
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Your consent is needed...
We would love to send you occasional newsletters about Hip Hop Pop, give you the chance to enter our competitions to win money off activities, and let you know about school holiday clubs and activities we run, and on occasion, let you know about extra dance workshops/classes, please
select YES below to allow us to contact you about the above
, or NO if you do not wish for us to contact you about the above activities and opportunities. Plase note you are welcome to opt-out of this at a later date should you wish to, simply by emailing jenny@hiphoppop.co.uk with the subject line 'opt-out of all indirect correspondence' *
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Yes
No
AND FINALLY... PLEASE READ THE TERMS AND CONDITIONS BELOW:
The terms below form an integral part of signing up to the membership (or in this case a Free Trial) with HIP HOP POP, please read, understand and agree by completing the by signing at the bottom 1. I am aware of and understand the potential risks and dangers associated with physical activity including the use of equipment and I am voluntarily participating in these activities with knowledge of the risks and dangers involved. 2. To the best of my knowledge I know of no reason why I should not participate in any of the classes and activities at Hip Hop Pop. I hereby declare myself free of any condition, disease, impairment, infirmity or illness that may affect my participation. I agree to inform a member of staff and where appropriate provide written consent from my doctor should such a condition arise, before continuing with any activity 3. I have had the opportunity to ask questions about the activities and classes and other related issues at Hip Hop Pop, and any questions I have asked have been answered to my satisfaction. 4. Hip Hop Pop accepts no liability for my death, injury or illness resulting from my failure to disclose any relevant medical impairment or condition or from my misuse of Hip Hop Pop’s facilities. 5. Hip Hop Pop takes no responsibility for items lost at their premises or third party premises although Hip Hop Pop will endeavour to help you recover such lost items. 6. I hereby give Hip Hop Pop permission to use photographs and video clips of the named student taking part in classes and activities at Hip Hop Pop for publicity channels including website, social media, posters and flyers etc. 7. I hereby agree to follow activity instructions by class leaders strictly to ensure correct techniques are used to avoid injury. 8. Hip Hop Pop Ltd, Schools Clubs Ltd and Productions Ltd, will look after your data with due care in accordance with GDPR 2018 and Privacy & Electronic Communications Regulations 2003. Your data will be processed for the direct purpose of having your / the students emergency contact details and to keep you informed of how to join us in full, this information is also vital to the safe operation of our sessions and allows us to contact you if there are any changes to your session. Sensitive data, including medical conditions will not be shared with any thrid party and forms an integral part of Hip Hop Pop being able to deliver safe sessions and activities. Your data will not be shared with third parties, you may from time to time receive direct purpose texts/emails from us regarding information your childs place in the club, for exmaple, confirming your place, letting you know performance times, or how to continue with us. By signing this form you understand how and why we are processing your data. Your data is captured via this form provided by 'formsite' whom encrypt your data collected form their secure form page. You are within your rights at any time to ask for access to the data we hold on you, we will happily provide you with said information at no cost to you. We do require you to keep us informed of any changes to your personal data when they arise, whilst you are a customer of ours, to ensure we meet GDPR regulations. You are also within your rights to be 'forgotten' if your data is no longer integral to the participantion of activity for the data subject. For further reading on our Data Protection Policy please contact jenny@hiphoppop.co.uk for a copy. We will require further information regarding any medical conditions (including where it's kept, how to and when to administer and/or an action plan) and it is your/the parents/guardians responsibility to bring the medication that may be required during any activity with Hip Hop Pop. Hip Hop Pop will not be held liable, should a student of any age be sent to / come to class without the correct medication (for the safety of all students, we must stress how important it is to bring required medication to all sessions).
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