Student Enrolment Form

Student Name*

First NameMiddle NameLast Name
Student Gender*
Birth Date*

DayMonthYear
Student Age*
School Student Attends (in 2026)*
Year Level at school (in 2026)*
Parent / Carer details

Person responsible for the enrolment and subsequent account
Parent / Carer Name*

PrefixFirst NameLast Name
Home Address*

Street Address

Street Address Line 2

Town/CityState

Post Code
Mobile Number*
Format: 0000 000 000.
E-mail*
example@example.com
Place of Employment
Emergency Contact

The following person can be contacted in an emergency when the Parent/Carer is unavailable.
Emergency Contact*

PrefixFirst NameLast Name
Relationship to Student*
Mobile Number*
Format: 0000 000 000.
Student Information
Is the Student:*

The sibling of an existing student?Aboriginal or Torres Strait Islander descent?Identified as Gifted and Talented by their School?Have a language background other than English?None of the above.
Are you aware of any medical conditions, diagnosis or disabilities?:*

YesNo
If you aware of any medical conditions, diagnosis or disabilities - please give details
Does your child have an emergency medical plan? Please attach a copy

Cancelof
Program Details

Please provide details of the lesson, group or ensemble the student is interested in
INSTRUMENT / GROUP / ENSEMBLE TO BE ENROLLED:*
LOCATION OF LESSON*

HRC Muswellbrook CampusSchool Based LessonsHRC Singleton Campus
Teacher Preference
Time Restrictions or helpful availability information
Lesson length details:*

Individual 20 minute lessonIndividual 30 minute lessonIndividual 45 minute lessonIndividual 60 minute lessonAdvanced Voice 30 minutesAdvanced Voice 60 minutesHarp 30 minutesHarp 60 minutesShared 30 min Lesson (subject to availability) - please contact usDramaEnsemble
INSTRUMENT ARRANGEMENTS*

Hire from HRC (Strings, Woodwind, Brass & Guitar Only)I have my own instrumentN/A
DECLARATION

By signing below, I accept full responsibility for the payments of all accounts pertaining to this enrolment as detailed on this enrolment form. I understand that non-payment of fees may result in referral to a recovery agent, and will incur collection fees.
Parent/Carer Signature (OR Student Signature if over 18)*
Date*

DayMonthYear
Date
AUTHORITY TO USE PHOTOGRAPHIC or VIDEO/FILM IMAGES

AUTHORITY TO USE PHOTOGRAPHIC or VIDEO/FILM IMAGES (for students under 18 yo)
Parent/ Guardian Signature*

Permission for photographic content -
Date*

DayMonthYear
Date
You're Almost There!!!

Just one last question to help out our Admin
How did you hear about the HRC?*

Referred by a friendRadio/Newspaperprevious enrolmentSchool recommendationSocial MediaGoogle/search engineOther
Sign me up to receive emails about concerts, workshops and new programs!

Sign me up please.
CREATIVE KIDS VOUCHERS

We LOVE Creative Kids vouchers!! The NSW Government is helping kids get creative with the new Creative Kids program. Parents, guardians and carers can apply for a voucher with a value of up to $100 per calendar year for each student aged 4.5 to 18 years old enrolled in school. The voucher can be used at any time during the calendar year it was issued.Apply for your voucher here: www.service.nsw.gov.au/transaction/apply-creative-kids-voucher _ Once you have a voucher - Enter the details on our website for processing.
Should be Empty:

Parent / Carer details

Emergency Contact

Student Information

Program Details

DECLARATION

AUTHORITY TO USE PHOTOGRAPHIC or VIDEO/FILM IMAGES

You're Almost There!!!

CREATIVE KIDS VOUCHERS