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Raffle Prize (Winners)

Raffle Prize (Winners)

£0.00

Enter details below for Raffle Prize Winners and please remember to enter which Class or Camp the Raffle Prize is for.

*Once this form has successfully been received, Boogie Pumps HQ will send an email confirming your child’s place

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Spaces Available

Which Class? *

Enter the name of the class you wish to attend.

Child’s Full Name(s) *

Child’s DOB *

Child’s Age *

Gender *

Educational School *

Child’s School Year *

For the term being booked

Medical Conditions or Educational Needs?

If yes, please provide any information we may find useful

Relation to Child *

Emergency Contact Number 1 *

Emergency Contact Number 2 *

Being Picked Up By *

Where did you hear about us? *

Other Information

New Customer?

Photo/Video Consent? *

Do you give consent for your child to be photographed and/or videoed during these sessions?

ADD a T-Shirt? *

Add a Boogie Pumps T-shirt (£10 + £3 shipping), select your size from the dropdown below. For personalised t-shirts and all other merchandise please see our online store.

Privacy Policy *

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