New Student Enrolment

New Student Enrolment

Please complete all boxes
Name of student enrolling

First NameLast Name
DAte of birth of student

DayMonthYear
Date
Name of parent/guardian (under 18)

First NameLast Name
Phone details

Mobile NumberHome Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
what class are you enrolling in
does the student have any medical conditions or current injuries that sdta need to be made aware of
If answered "YES" what is the medical condition or Injury Medical condition. If medication is needed in lessons please specify Medication needed.
do we have permission to photograph the student ?
Do you give permission for SDTA teachers to administer first aid if needed
Data Protection

Synergy Dance Training Academy will process your confidential information – which includes students and Parents/Guardians names, contact details, date of birth, relevant medical history, only for the purposes listed below.
- For the purpose of administration in connection with dance classes
- Supply of information and examination paperwork to NATD/IDTA
- Supply of information and registration paper to competition organisations/companies
The data will be stored securely with the use of password protection, and will not be stored longer than necessary and solely for the completion of those business activities.
i consent to the above
prefered contact method
Signature
Should be Empty: