Child's Details
Child's First Name
*
Child's Last Name
*
Child's Age
*
Child's Birth Date
*
-
Day
-
Month
Year
Date
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Parent/Guardian's Details
Parent/Guardian's First Name
*
Parent/Guardian's Last Name
*
Relationship to Child
*
Email
*
Confirmation Email
example@example.com
Postal Address
*
Street Address
Street Address Line 2
Suburb
State / Province
Postcode
Home/Work Telephone
Mobile
*
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Class Enrolment
Monday
Select Your Child's Preferred Class
7th October
14th October
21st October
28th October
4th November
11th November
18th November
25th November
Friday
Select Your Child's Preferred Class
11th October
18th October
25th October
1st November
8th November
15th November
22nd November
29th November
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About Your Child
Does your child have any existing medical conditions?
*
No
Yes
If yes, please give specific details of this condition. How can we best manage this condition while the student is in Session?
Does your child have any existing special needs?
*
No
Yes
If yes, please give details of these needs and how we can bet manage these during a lesson.
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We're almost done...
How did you hear about The DECADANCE ?
Word of Mouth
Website/Google
Facebook/Instagram
In person at the studio
Other
Occasionally we take photos or videos of our sessions for promotional purposes. Do you consent to media usage?
*
Yes
No
I would like to discuss this further
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Terms and Conditions
Please verify that you are human
*
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