2025 Enrolment Form

ExtravaDance 2025 Enrolment
Student 1 Information
Name*

First NameLast Name
Birthdate*

DayMonthYear
Date
School attended:
Medical conditions
Port Studio- Press/hold CTRL to select multiple classes
Wauchope Studio - Press/hold CTRL to select multiple classes
Student 2 Information
Name

First NameLast Name
Birthdate

DayMonthYear
Date
Medical conditions
School attended:
Port Studio- Press/hold CTRL to select multiple classes
Wauchope Studio - Press/hold CTRL to select multiple classes
Student 3 Information
Name

First NameLast Name
Birthdate

DayMonthYear
Date
Medical conditions
School attended:
Port Studio- Press/hold CTRL to select multiple classes
Wauchope Studio - Press/hold CTRL to select multiple classes
Parent/Guardian information
Parent/Guardian 1*
Phone Number*

Area CodePhone Number
Email *
example@example.com
Parent/Guardian 2 (if applicable)
Phone Number

Area CodePhone Number
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Additional Emergency Contact - *NOT PARENT* (in the event that we cannot contact parents or guardian)*

My Products

Enrolment fee (child 1)$50.00AUD

Enrolment fee (child 2)$46.00AUD

Enrolment fee (child 3)$42.00AUD

Total $0.00AUD

ExtravaDance 2025 Enrolment