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Centre Stage Dyslexia Enrolment Form
Pupil Name
Pupil Date of Birth
Parent/Guardian Email
Emergency Contact (Name):
Emergency Contact (Number)
Any medical conditions/medication?
Any information regarding your child's neurodiversity you would like us to know?
I consent to my child to being photographed/filmed for use within the following purposes (please tick):
Internal Education (eg. during rehearsal process/class activities)
Live Performances (eg. to a public audience)
Digital Marketing (on our website, social media & email campaigns)
Print Marketing (printed adverts, flyers, posters)
None of the above
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