Enrolment Form
Please fill in the form below.
Parent/Guardian Information
Parent 1 Name
*
First Name
Last Name
Parent 1 Mobile
*
Parent 2 Name
First Name
Last Name
Parent 2 Mobile
Address
*
Street Address
Street Address Line 2
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Best E-mail for communication
*
Person responsible for paying fees and other associated costs
Parent 1
Parent 2
Other
Would you like to pay for your child's tuition fees via fortnightly direct debit or the full term upfront? If you choose to pay via fortnightly direct debits, you will receive an email with an online form to complete to set up your Ezidebit account. If you choose to pay for the term up front you will receive an invoice that is payable within 7 days.
Fortnightly direct debit
Full term payment upfront
Student Information
Student Name
*
First Name
Last Name
Student Gender
*
Female
Male
DOB
*
DD/MM/YYYY
Address
*
Same as Above
Other
School Attending
Name of School
What class/classes would you like to enrol into? If you are enrolling into a preschool class please indicate the day that you wish to enrol into
*
Please indicate if your child has had any experience in dance before. If so, please list what styles, levels, exam grades completed.
Emergency Contact Details
Emergency Contact Name
*
First Name
Last Name
Relationship to Student
*
Aunty/Uncle/Family Friend
Phone Number
*
General Information
Does your child have any medical conditions?
*
No
Other
Does your child take any regular medication?
*
No
Other
Does your child have any dietary requirements?
*
No
Other
Does your child have any diagnosed conditions that Raz Studios should be aware of?
*
No
Other
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge and should any of the provided information change I agree to forward it to Raz Studios.
*
Yes
I have read and understand the terms and conditions as outlined in the Raz Studios Policy and Information Booklet. I am aware that all fees are payable by the dates set out in the Policy and failure to have the client account up to date will result in administration fees and my child not being able to participate in classes. I acknowledge that partaking in Dance activities comes with associated risk of potential injury and I agree to waive any and all claims of liability against Raz Studios in the event of injury, permanent damage or death. In the event of an accident I hereby give Raz Studios staff permission to provide medical attention where deemed necessary. I acknowledge that the end of year photo day are compulsory events for all students enrolled at Raz Studios whom wish to partake in the annual concert.
*
Signature
*
Please sign in the space provided above
Please verify that you are human
*
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Registration Fee (Required)
$
35.00
AUD
Payment required at time of registration
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$
0.00
AUD
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