Course Registration Form

Parent details

Parent First NameParent Last Name

Student details

Student First NameStudent Last Name

Gender

Birth Date

DayMonthYear

Address

Street Address

Street Address Line 2

CityState

Post code

PARENT EMAIL ADDRESS

example@example.com

mobile number

Format: (000) 000-0000.

Phone number

Format: (000) 000-0000.

Work Number*

Format: (000) 000-0000.

CLASS FEES for each term are due and payable at the end of week 3 of each term. PRIVATE LESSONS fees must be paid in full at the commencement of each term.

Day of class or additional classes can be added here.

Class choice*

please choose your classes and use the additional information box below to choose the day of the class or to add more classes

Medical conditions/injuries/allergies or disorders

additional information

FEES ANNUAL ADMIN AND ENROLMENT FEE $40 for junior students $50 for seniors. CLASS DISCOUNTS D3,4,5 or 6. CLASS DISCOUNT- D3=5%, D4=10%, D5=10%, D6=15% FD=TWO OR MORE STUDENTS- FAMILY DISCOUNT = 5% CLASS FEES 30min: $11.00 ($110 a term), 45min: $13.50 ( $135.00 a Term), 60min: $16.00 ($160 a Term) No discount applies to private lessons (code PL) Private Lessons $45.00 per half hour. Unattended Private Lessons without written notice will be charged at the full rate.

Additional information

Please use the tick boxes, to agree to the terms and conditions.

I/we give permission to take my child to the nearest hospital or doctor for medical attention if the need arises.I/we give permission to use concert or general school photos for social media and on the school website at http://www.hpac.net.auI/we agree to my child being enrolled at HPAC and understand that my child will be dancing at his/her own risk.I/we understand and agree thart HPAC does not accept any liability for loss, damage or injury.I/we will email or provide written notice to HPAC accounts when a class which has been invoiced will no longer be attended.I/we acknowledge that the class or family discount will be deleted from the Term invoice if not paid by the due date.I/we acknowledge that physical contact may be necessary by members of the teaching faculty.