SECTION 1: STUDENT DETAILS
First Name (required)

Last Name (required)

Date of Birth (required)

Gender (required)
MaleFemale

Mobile Number(required)

Email (required)

Address (required)

Post Code (required)

SECTION 2: EMERGENCY CONTACT DETAILS OF PARENT / GUARDIAN / NEXT OF KIN
(to be completed in all cases)

Title
MrMrsMsDr

Full Name (required)

Relationship to Student (required)

Mobile Number(required)

Email (required)

SECTION 3: CLASSES

Select the Dance classes you are enroling for:
Bollywood DanceBharatanatyamThiruvathiraStreetDanceMohiniattam

Select the Music classes you are enroling for:
ChendaTabalaMridhagamKeyboardGuitarViolinVocal

Select the language classes you are enroling for:
Malayalam ChildMalayalam Adult

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