First Name *Last Name: *Phone: *Email Address: *Date of Birth:DayMonthYearCountry of Residence: *Gender: *GenderFemaleMaleNon-BinaryPrefer not to sayWhy do you want to attend? *How did you hear about us? *Please select an option-FacebookGoogle searchFrom a friend or associateCame across your websiteOtherAny injuries or disabilities we should know about? *Anything else?Emergency contact name: *Emergency contact number: *By submitting this form you confirm the following: 1. All information provided by you is correct. 2. The deposit confirms your place and is non-refundable. 3. Should the required numbers not be reached, School of Play reserves the right to cancel the workshop. In such case, all payments will be refunded. 4. I acknowledge that I am physically and mentally fit and that although every care will be taken, when participating in physical movement there is always the possibility of physical injury. I assume full responsibility for any injuries that might occur, and agree to release and discharge School of Play facilitators from any and all claims arising from the workshop. *Yes, I agree with the terms and conditions.I would like to receive International School of Play emails (maximum two per year):-YesNoRegisterPlease do not fill in this field.
