2018 Online Enrolment Form

Adult Dancer Details
ADULT ENROLMENT 2025
Adult Dancer Name:*

First NameLast Name
Adult Dancer DOB:*

DayMonthYear
Mobile:*
Email for invoicing & Newsletters*
example@example.com
Gender; this helps us with class planning:*

MaleFemale
Are you new to dancing?

I have a few years dance experiece - began as an adultI have danced through my childhood years through to adulthoodI have never danced beforeOther
What classes will you be enrolling in?*

Adult BalletAdult Hip Hop BeginnerAdult Hip Hop IntermediateAdult TapAdult JazzPrivate LessonAdult Ballet Exam class
Please add any other information which we might find useful. E.g. Medical conditions or allergies etc.
Alternative Emergency contacts details:*
How did you hear about classes at BIM:
I Agree to the Terms & Conditions of Enrolment (see below) and agree to the fee schedule as assigned to the class I am enrolling into? I wish to choose the following payment option:*

Payment on invoice within the 14 day payment termI would like to use one of your payment plan options. Please send me more information.
INJURY RISK: Whilst all due care is taken, I am aware that participation in dance classes and other organised activities in conjunction with Bodies in Motion Dance School could result in some possible personal injury. Despite precautions taken by the studio, accidents and injuries may occur. By agreeing to this release statement, I assume all risks related to the use of any and all spaces used by Bodies in Motion Dance School. I agree to release from responsibility Bodies in Motion Dance School, including all teachers, dancers, staff members, and facilities used by said entity from any cause of action, claims, or demands now and in the future. I will not hold Bodies in Motion Dance School liable for any personal injury including: scrapes, bruises, cuts, sprains, fractures, broken bones, concussions or any personal property damage/loss, which may occur on the premises before, during or after classes. This is a compulsory term of enrolment.*

I agree
PHOTOGRAPHY/ VIDEOS – I am aware that from time to time, videos and photographs from classes or events are used to promote our programs through social media and other advertising.*

I am aware
How do you wish to pay your annual $35 Registration Fee?*

PayPal - you will be taken to an external link to processBank Transfer: BIM BSB:014663 ACC:414855703Cash or EFTPOS at the office
Annual Enrolment Fee Payment:
prevnext( X )
Enrolment Registration Fee$35.00AUD

Total $0.00AUD
Should be Empty:

Adult Dancer Details