SummerI nternational Dance Course For Parent/Child

Application Form 課程報名表

* Required 必須填寫

Child English First Name 小朋友英文名字*

Child English Surname小朋友英文姓氏*

小朋友中文名 Child Chinese Name (Optional)

ChildreBirth Date 小朋友出生日期

Parent English Full Name同行家長英文姓名＊

同行家長中文姓名 Parent Chinese Name (Optional)

Parent Contact Phone (can use Whatsapp)家長聯絡電話 (可用Whatsapp)＊

E-mail 電郵

Relationship 關係

Emergency Back Up Contact Phone 緊急後備聯繫電話＊

Course Enroll 報讀課程: (Can pick more than one 可選多於一個)

1) Summer Belly Dance Parent/Child Class暑期肚皮舞親子班: 22/7, 29/7, 5/8, 12/8 (Sat六) 9:45am-10:45am

2) Summer Indian Bollywood Dance Parent/Child Class A暑期肚皮舞親子班 Class A: 22/7, 29/7, 5/8, 12/8 (Sat六) 2:30pm-3:30pm

3) Summer Indian Bollywood Dance Parent/Child ClassB暑期肚皮舞親子班 Class B: 23/7, 30/7, 6/8, 13/8 (Sun 日) 9:30pm-10:30pm

4) Summer Hawaiian Hula Dance Parent/Child Class 暑期夏威夷舞親子班23/7, 30/7, 6/8, 13/8 (Sun 日) 10:45am-11:45am

Is it 2 Groups (2 Adult + 2 Children) join together? 是否2成人+2小朋友同行夏季親子班

Yes 是

No 不是

If Yes, please name another children full name. 如是, 請註明另外一名小朋友姓名

Any specific question you would like to know? (Optional) 有其他任何問題想了解嗎?（可沒有）

Do you agree to receive our course information and promotion? 閣下是否同意接收我們有關課程及優惠資訊?

Yes 願意

No 不願意

I have read the Te and accept the terms and conditions in this agreement. *本人已閱畢及接受條款及細則

View Terms and Conditions 查看條款及細則

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