2023 Pre-school program ENROLLMENT FORM

ENROLLMENT FORM 2023
Melani School of Dance has always respected the privacy, security and online safety of the member's personal information. We take our responsibility to protect their information very seriously. Information is stored in a file and / or on a computer. Once a member opts out of receiving information from Melani School of Dance, all information is immediately destroyed by shredding if printed on paper / deleting if stored on a computer. We assure you that your privacy remains our priority.
BalletModern DanceTapAcrobaticsAdult dance class
Dancer's Name (as per certificate)*

First NameLast Name
Grade at school?*
Melkbos Kids AcademyMelkbos Pre-primaryNoah's ArkThe Little FellowshipGenerationsMPP SEASPRITESOther
Class at school's name
FOR OFFICE USE
Dancer's Date of birth*

MonthDayYear
Date
Age as per the 1st of January 2023*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mothers' Name*
Mothers' Phone Number*
Please enter a valid phone number.
Mothers' Email (general info)*
example@example.com
Fathers' name*
Fathers' phone Number*
Please enter a valid phone number.
Notes to Teacher
Method of payment*
ACCOUNT HOLDER ID Number*
DEBIT ORDER MANDATE FOR MONTHLY FEES
Accounts Email*
example@example.com
T-shirt size*
Please tick box as applicable. I agree to:
NEW STUDENTS
How did you hear about us? Who is your referral?
Previous dance training and where?
I hereby declare that I understand the terms and conditions and understand that this registration contract represents a financial commitment for the classes I have indicated above. I do hereby accept full responsibility for the full settlement of the account when it is due at the beginning of each month. I have read the registration information and understand the school's calendar and policies as outlined. I declare that all information submitted by me is complete and accurate.*

Clear
Disclaimer: The information contained in this communication from the sender is confidential. It is intended solely for use by the recipient and others authorized to receive it.
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ENROLLMENT FORM 2023

NEW STUDENTS

Disclaimer: The information contained in this communication from the sender is confidential. It is intended solely for use by the recipient and others authorized to receive it.