Back to Broadway Musical Theatre Schools – Application Form

Please do contact us if you have any questions. Tel: 01963 365898

This Form must be completed BEFORE making payment on the secure PAYPAL page.

IF you wish to pay by cheque, please complete the form > Click on Submit and then send the cheque, payable to Back to Broadway Ltd, to:

Back to Broadway Ltd
Tel: 01963 365898
xxxx
xxxx

School Area:

Applicant's Name: Age: DOB:

Sibling's Name's (if attending): Age: DOB:

Parent / Guardian Name:

Relationship to Applicant:

Full Address:

Post Code:

Home Telephone: Mobile:

Email Address:

Emergency Contact Name: Telephone:

Any Medical Conditions?:

Permission to Appear in Term Video:

Permission to Appear in Web photos:

T–shirt sizing. Ch: chest. le: length. (Tshirt measured flat across front, under arms, and from back neck to hem) SY: ch.15’’ le.19’’ MY: ch.16.5’’ le. 21’’ LY: ch.18’’ le.22’’ S: ch.18’’ le.26’’ M: ch.19’’ le.27.5’’ L: ch.22’’ le.29’’

T– Shirt Size required:
T– Shirt Sibling Size (optional):

FEES: COURSE FEE PER STUDENT: £130

I agree that you may email from time to time with further relevant information of upcoming promotions and events.

DEPOSIT PER STUDENT: £30 NON-RETURNABLE. If Back to Broadway cancels the school, your deposit will be returned.

BALANCE DUE: ONE WEEK PRIOR TO COMMENCEMENT OF COURSE.

PARENT/GUARDIAN DECLARATION:

I agree to pay the balance of £100 (£90 for 2009 students) one week prior to the commencement of the course. I understand that Back to Broadway reserves the right to exclude students whose behaviour is disruptive. I understand that my child(ren) will attend between the hours stated for your school There is no provision for care outside these hours.

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