In order to attend a class at The Dance Base, you must have filled out the form below.

First Name

Email Address

Last Name

Date of Birth

Have you had any of the following COVID-19 symtpoms within the last 14 days?

A high temperature

A new or continuous cough

A loss or change in your sense of smell / taste

None of the above

Initials

Today's Date

I declare that the info I’ve provided is accurate & complete

Thank you for helping us to keep The Dance Base a safe space!

07795050229

thedancebase@googlemail.com