BBO Scholars Weekend
Saturday 26th and Sunday 27th October 2013
Elmhurst School for Dance, Birmingham
SCHOLAR BOOKING FORM – BOOKING DEADLINE: MONDAY 21ST OCTOBER 2013
ALL Scholars are expected to attend the weekend as part of their Scholarship.
THE ATTACHED “PARENTAL MEDICAL CONSENT FORM” MUST BE RETURNED WITH THIS BOOKING FORM
Name:
Date of Birth:
Address:
Male / Female:
Age (at 26th October 2013):
Postcode:
Telephone:
Email:
Further information will be sent by email once your booking form has been processed. If you have not
received an email within 14 days of applying please contact BBO Headquarters at [email protected]
PLEASE  APPROPRIATE BOX
£165
Residential Student – Course fee includes:
All meals refreshments, accommodation, coach travel & classes
Non Residential Student – Course fee includes:
All classes, lunch & refreshments
£110
PLEASE CIRCLE THE SCHOLARSHIP SCHEME YOU ATTEND
Junior Ballet South
Junior Scottish
Junior Ballet North
Jazz North
Senior Scottish
Senior Ballet
Jazz South
Male Scholars
Dietary Requirements: _________________________________________________________________________
Room Sharing:
For this event, we will be using triple bedrooms. Please note that room sharing requests cannot be guaranteed –
although we usually experience no problems in accommodating all wishes.
1. ___________________________________________
2. ___________________________________________
Payments to the BBO
You can make a payment to the BBO in the following ways:
1. By Cheque (payable to: BBO)
2. Credit/debit card
Amount To Pay: £_______________
Name on card: _______________________________________
Card Number: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
Expiry Date: ____/____
Security Number (the last 3 digits on the back of the card): __ __ __
3. By BACS transfer directly into our bank account. If you chose to make payment this way then please ensure you
send an email to [email protected] with the following details:
Your Name
Your daughter/son’s name
Date the payment was made
Payment amount
Please also ensure that this booking form is emailed to [email protected] or posted to the address at the bottom of
the page.
Account Details
Bank:
Account Name:
Sort Code:
Account Number:
Natwest Bank, 149 Church Road, Barnes, London SW13 9HS
British Ballet Organization
60-01-39
35591668
Refund Policy
If a student withdraws from the course due to illness/injury or personal mitigating circumstances (e.g. serious injury
or bereavement) then the following refund policy will apply.
If withdrawal is made up to Monday 7th October 2013;
The full course fee will be refunded less a £25 administration fee.
If withdrawal is made after Monday 7th October 2013;
50% of the course fee will be refunded less a £25 administration fee.
All refund requests must be sent in writing and received no later than Monday 4th November 2013.
Please include all documentary evidence (such as a medical certificate) when applying for a refund.
Please return completed form to:
Scholars Weekend, BBO, 39 Lonsdale Road, Barnes, London SW13 9JP
or
[email protected]
Tel: 0208 748 1241
British Ballet Organization
Scholars Weekend, October 2013
Parental consent form
I give permission for my child to take part in BBO’s Scholars Weekend 2013 at Elmhurst School for Dance, Birmingham.
I acknowledge that the British Ballet Organization Staff & Housemothers will take all reasonable steps throughout the
course to prevent her / him from any accidents or other harm. I understand that in the event of an accident or other
emergency every effort will be made to contact me. If staff are unable to make contact, I agree to the person in charge
of the group giving consent on my behalf for any urgent medical treatment which is deemed necessary by a qualified
medical practitioner (including transportation to hospital, blood transfusion and a general anaesthetic) and accept that
such a practitioner will need to be informed of any condition / medication previously disclosed to the BBO.
I understand that photographs may be taken at this event for publicity purposes.
Please provide details of any relevant illnesses/injuries and any regular medication:
Next of Kin: ________________________________ Relationship __________________
Emergency contact telephone numbers: _______________________________________
_______________________________________
Signed: ______________________________________________
Print Name: ___________________________________________
Parent / Guardian of: ____________________________________
Date: ___ / ___ / 2013
Download

2013-SW Scholar Booking Form