Workshop registration form

please fill out this form for health and safety purposes.

* Indicates required field

Name *

First

Last

Email *

Telephone number *

Name of person we can contact in case of emergency *

Telephone number of above person *

Do you have any medical conditions or special learning requirements that we need to be aware of? *

In order to attend these workshops you need to agree that neither HoopHoopHoop, Steve Bags nor Valentina Martin accept responsibility for injury or death sustained by you whilst pooping or belly-hoop-dancing at the workshops you are attending on Sunday 1st December. Do you agree? *

How did you hear about this workshop? *

Would you like to receive emails (about 4 per year) about other hoop dance or circus events organised by HoopHoopHoop? *

Submit