EPIC STUDIOS AUSTRALIA
SPECIALTY PROGRAM REGISTRATION
Student Details
Student Name
*
First Name
Last Name
Student DOB
*
-
Day
-
Month
Year
Date
Allergies/ Medical Information
*
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Parent/ Guardian Information
Parent 1 Full Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact - must be different to parent/s listed above
*
First Name
Last Name
Emergency Contact Phone Number
*
-
Area Code
Phone Number
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Registration
The below registration fee is for 1 full term only. Please see individual program information for specific dates and times that each program will run during the term.
Please elect your desired program
*
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INDUSTRY THURSDAYS 8-11yrs
$
110.00
AUD
INDUSTRY THURSDAYS 12yrs - OPEN AGE
$
220.00
AUD
CLASSICAL DEVELOPMENT 8-10yrs
$
132.00
AUD
CLASSICAL DEVELOPMENT 11-12yrs
$
176.00
AUD
CLASSICAL DEVELOPMENT 13yrs & over
$
220.00
AUD
CIRQUE EXTENSION PROGRAM
$
220.00
AUD
Credit Card
Submit
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