Greenwich Dance Center Enrollment
Please fill out carefully as information will be used in exam entries, emergencies and COVID-19 contact tracing
Parent/Carer/Emergency Contact Name
First Name
Last Name
Email
example@example.com
Home Phone Number
-
Area Code
Phone Number
Mobile Number
Second (backup) Emergency Contact
Number
Dancer's Primary Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Dancer 1 - Full Name
Date of Birth
Classes you wish to enroll in:
Medical Info
Dancer 2 - Full Name
Date of birth
Classes you wish to enroll in:
Medical info
Dancer 3 - Full Name
Date of birth
Classes you wish to enroll in:
Medical info
Do you give permission for images of your child to be used for promotional purposes?
YES
NO
COVID-19 Waiver
I agree not to send my child to dance if they have any cold/flu symptoms
I have taught my child to socially distance appropriate to their age
I understand anyone entering the studio must use hand sanitiser/soap and water
I will pickup my child immediately and agree to their isolation in the office if they develop symptoms during class.
Signature
Submit
Should be Empty: