Free Trial Form - Saturday 19 June 2021
Dance & Fitness Classes @ Eastern Gymnastics Academy, Waterloo - 12.00pm to 3.00pm
Student Date of Birth
Street Address Line 2
State / Province
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Contact Phone Number
Other Siblings/Children's Names & Ages
Register for Free Trial Lessons
Saturday 19 June 2021 - 12pm to 3.00pm
Which Dance Class/es would you like to trial?
Kindergarten to Year 1 Ballet: 12.00pm - 12.20pm
Kindergarten to Year 1 Jazz: 12.30pm - 12.50pm
Year 2 to Year 3 Jazz: 1.00pm - 1.20pm
Year 2 to Year 3 Hip Hop: 1.30pm - 1.50pm
Year 4 to Year 6 Hip Hop: 2.00pm - 2.20pm
Year 3 to Year 6 Contemporary/ Lyrical: 2.30pm - 2.50pm
Do you suffer from any health complaints? Eg. asthma, allergies, diabetes,blood pressure, cholesterol, arthritis, skin disorders (acne, rashers, psoriasis, eczema) chronic fatigue, other?
Please provide and explain.
Any other health conditions, current or past injuries?
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