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Exam Consent Form

Submit this form to consent to your child participating in an exam

First Name

Students Name (To be printed on certificate)

Last Name

Students DOB

Exam Type (price includes 1 hour studio time)

Pre-Primary Ballet (£39)

Primary Ballet (£49)

Grade 1 Ballet (£50)

Grade 2 Ballet (£52)

Grade 3 Ballet (£56)

Grade 4 Ballet (£59)

Grade 2 Acting (£54)

Grade 3 Acting (£58)

Grade 4 Acting (£66)

Grade 5 Acting (£71)

Initial Musical Theatre (£45)

Grade 1 MT (£48.00)

Grade 2 MT (£54.00)

Grade 3 MT (£58)

Grade 4 MT (£66.00)

Grade 5 MT (£71.00)

Grade 1 Singing (£55.00)

Grade 2 Singing (£63.00)

Grade 3 Singing (£71.00)

Grade 5 Singing (£83)

Grade 6 Singing (£95)

Pre-Syllabus Tap (£32)

Pre-Primary Tap (£44)

Primary Tap (£47)

Grade 2 Tap (£52)

Grade 1 Tap (£50)

Grade 3 Tap (£55)

I consent to my child taking this exam

No

Yes

I consent to my child being filmed for the purposes of this exam.

No

Yes

I understand that any fees payable are non refundable

Signed

Today's Date

Thanks for submitting!

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Email: thepatheatreacademy@gmail.com ~ Tel: 07920755791 / 07920140281

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