Enrolment

Enrolment Form

Child's Full Name*

First Middle Last

DOB*

Email*

Enter Email Confirm Email

Phone

Mobile*

Address*

Street Address City State / Province / Region Post Code Country

Emergency Contact Details

Name*

First Last

Phone

Mobile*

Relationship*

Add another Emergency Contact?

Add another Emergency Contact?

Name*

First Last

Phone

Mobile*

Relationship*

Class

*Please note from Primary - Grade 4 Ballet students attend twice per week, examinations are compulsory for all students who are invited to undertake an examination from Primary upwards.

VOCATIONAL STUDENTS

GRADE BALLET STUDENTS

Tap - What Grade?

Jazz - What Grade?

Jazz CSTD - What Grade?

Medical Conditions

Medical conditions & other factors influencing learning capabilities.

Parent/Guardian Approval

Terms & Conditions (Parent/Guardian)*

I agree to the following:

I hereby give permission for my child to participate in dance classes. I fully understand this is at my child’s own risk and that all care will be taken with students, but no responsibility will be accepted by the school or those involved with the school. Some physical contact may be necessary by the teacher to demonstrate exercises or techniques, or if a member of the staff needs to administer first aid. In the event of a medical emergency and where a parent cannot be contacted, I authorise the dance school to seek medical advice/attention for my child at a hospital or medical centre. I adhere to the Debra Whitten School of Dance Terms and Conditions as outlined in the School Prospectus. I will participate in the 2020 annual concert and ensure all fees are paid on or prior to the due date. If invited to undertake an examination I will participate in the examination and holiday classes.

Parent/Guardian Signature*

Parent/Guardian Name*

Date*

At the Debra Whitten School of Dance we welcome students of all ages and different levels offering an environment for your child that is supportive and encouraging.

Enrolment Form

Emergency Contact Details

Class

Medical Conditions

Parent/Guardian Approval

Secure your child’s position in 2018!