Student Enrolment Form
NEWCASTLE FLAMENCO DANCE
Name:
*
First Name
Last Name
Type of enrolment:
Family enrolment
Individual enrolment
$25 trial class
Birthday:
*
-
Month
-
Day
Year
Date
Email:
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Number:
*
Please enter a valid phone number.
How long have you been dancing flamenco for?
Please choose which class/classes you would like to join:
*
Adults Beginners Flamenco, Tuesday Mayfield 6-7 pm
Adults Intermediate Flamenco, Tuesday Mayfield 7-8 pm
Gypsy Gym, Wednesday Mayfield 5:30-6:30 pm
Adults Advanced Flamenco, Wednesday Mayfield 6:30 - 7:30 pm
Gypsy Gym, Thursday Hamilton 9:30-10:30 am
Gypsy Gym, Thursday Gosford 5:30-6:30 pm
Adults Beginners Flamenco, Thursday Gosford, 6.30 -7:30 pm
How did you hear about 'Newcastle Flamenco Dance'?
Do you give 'Newcastle Flamenco Dance' permission for the student to be photographed and videoed for promotional purposes?
Yes
No
Sign up to receive updates about new classes, workshops & performances:
Yes,please
No, thanks
Signature:
Submit
Should be Empty: