Angela Routledge April 23, 2018 LA Acro Dance New Dancer Application Form Angela Routledge April 23, 2018 LA Acro Dance New Dancer Form Dancers Name * First Name Last Name Date of Birth Age Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Home Telephone Number Name of Parent/Guardian * Parent/Guardian Mobile: * Parent/Guardian Email Address Emergency Name & Contact Number: (Different From Above) Ballet And Jazz Grade: (Or Dance Experience ) Gymnastic/Acro experience Yes No Acro Skills? Splits Handstand Bridge Cartwheel Forward Walkover Back Walkover Aerial Back Handspring None, I'm a beginner Health: I confirm that the above named Student is fit and healthy and able to participate in the class/es applied for: * Yes No (if no please give details) Please state any medical or physical conditions, including allergies, that may affect the named student. PERMISSIONS Photography At times we may wish to take photographs or film footage for use on the LA Dance Acro website, advertising or similar for which we request your permission. Please complete and sign as appropriate I give permission for photographs or film footage to be taken of the named student and authorise the use of them in LA Dance Acro related publications. Yes No It is understood that the permissions have been provided and will remain in place for the duration of the named dancers attendance at LA Dance Acro unless notified to the school in writing. * Agree WAIVER I am aware that participating in dance and acrobatic dance involves inherent risks and hazards. I understand and freely accept and fully assume all such risks, dangers, and hazards and the possibility of personal injury, property damage, or loss resulting from such risks and hazards. I voluntarily agree to release LA Dance Acro, Angela Routledge and Lisa Bailey from any and all liability for any loss, damage, injury or expense that I or my next of kin, successors or dependents may suffer or incur as a result of participation with this class/es. * Agree As the Parent or Guardian of the above named student, if I cannot be contacted, I authorise LA Dance Acro to seek medical services in case of serious injury or illness. I understand that LA Dance Acro, Angela Routledge and Lisa Bailey will not assume responsibility for any lost or stolen property, or for any bodily or personal injury consisting of or arising out of any participation in any physical training or athletic activity. I confirm that the above information is all true and that I will inform LA Dance Acro of any important changes to the Students heath, medication or needs. I will also advise of any changes to the contact details given above. * Agree Participants (or if under 18, Parent or Guardian) Name: First Name Last Name Date MM DD YYYY Please note that all participants (or, if under age of 18, their Parent or Guardian) are required to fill in this waiver. LA DANCE ACRO DATA PROTECTION POLICY 1. All personal information that is collected from you will be used solely by Angela Routledge Pilates and/or LA Dance Acro) and kept filed securely in accordance with the Data Protection Act 1998. You reserve the right to request a copy of all data I hold about you at any time. 2. All new class participants are required to fill out and sign either a Health Assessment Questionnaire or New Student Waiver Form, either online or a paper copy at class. These forms are securely stored and are only accessed by Angela Routledge for Angela Routledge Pilates and Angela Routledge and Lisa Bailey for LA Dance Acro. At the beginning of each term, if you have notified us that you are leaving or unsubscribed from the mailing list, your online forms will be deleted and paper forms will be destroyed. 3. For the purposes of communication about the classes, timetable changes, events, updates and class cancellations I ask every participant for an email address. This is the only form of data I ask for apart from the signed Health Assessment Questionnaire or New Student Waiver Form. Supplying your email address is not obligatory. However without your contact information it is not possible to contact you about class changes or cancellations. 4. All email addresses are entered on to a secure mailing system. There is a link available to unsubscribe on every email sent. NO email addresses are passed on to any one person or third party companies. * I have read your data protection policies and agree to the terms and conditions. LA DANCE ACRO SAFEGUARDING POLICY This policy applies to all staff, volunteers and students or anyone working on behalf of LA Dance Acro. The purpose of this policy is: • To protect children and young people who receive La Dance Acro services. This includes the children of adults who use our services; • To provide staff and volunteers with the principles that guide our approach to safeguarding LA Dance Acro believes that a child or young person should never have to experience abuse of any kind. We have a responsibility to promote the welfare of all children and young people and to keep them safe. We are committed to practice in a way that protects them. Legal Framework This policy has been drawn up on the basis of law and guidance that seeks to protect children, namely: • Children Act 1989 • United Convention of the Right of the Child 1991 • Data Protection Act 1998 • Sexual Offences Act 2003 • Children Act 2004 • Protection of Freedoms Act 2012 • Relevant Government guidance on safeguarding children This policy should be read alongside the LA Dance Acro Terms and Conditions. We recognise that: • The Welfare of the child is paramount, as displayed in the Children Act 1989 • Some children are especially vulnerable due to the impact of previous experiences, their level of dependency, their communication needs or other issues • All children regardless of their age, disability, gender, race, religious beliefs, sexual orientation or identity, have the right to equal protection from harm • Working in partnership with young people and their parents is essential in promoting the welfare of those we need to protect. We will aim to keep children safe by: • Valuing them, listening to them and respecting them as individuals • Implementing thorough procedures and practice for staff and volunteers which adopts child protection best practices • Maintaining an effective e-safety policy • Providing effective management for all staff and volunteers through supervision, support and training • Recruiting staff and volunteers using safer recruitment best practice, ensuring all necessary checks are completed • Sharing information about child protection and good practice with children, parents, staff and volunteers • Sharing concerns with relevant agencies and involving parents and children appropriately • Ensuring that we provide a safe environment for our pupils, staff and volunteers. • Informing all visitors of LA Dance Acro policies and safeguarding expectations We are committed to reviewing our policy and good practice on an annual basis. This policy was last reviewed on: 23rd April 2018 * I have read and agree to your safeguarding policy! Thank you, your dancer is now able to participate in LA Dance Acro Classes!
