Passion for Dance Academy Sign-Up Form
Student Name
First Name
Last Name
Student Date of Birth
Student Gender
Female
Male
Grade at School
School Attending
Signing Up for
Ballet
Modern
Contemporary
Physical Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Main Contact Person Name
First Name
Last Name
Main Contact Number
Main Contact Email
Secondary Contact Person Name
First Name
Last Name
Secondary Contact Number
Secondary Contact Email
Any Medical Information - Allergies/Medical Conditions
Please take note of the following: - Students must wear appropriate covering when coming to and leaving the studio (dress, shorts, skirt over uniform) - One month's, paid notice is required should you wish to terminate the contract - No Parents allowed inside the venue during lessons unless they are invited to a parent viewing or showcase - Students must arrive at least 5 minutes before the start of their lesson - All clothing must be clearly marked (skirts, jerseys, shoes etc.) - Hair must be tied back out of the face (preferably into a bun)
Please Select
Yes, agreed
I hereby waive any claim, which I may have against Passion for Dance Academy or any of its staff or management for any damages sustained by any person which may arise in connection with the tuition by aforementioned whether such damage arise as a result of theft, loss of life, bodily injury or any other cause whatsoever. This waiver is unconditional and is given both in my personal capacity as client/mother/father and/or natural or legal guardian of any minor concerned.
Please Select
Yes, agreed
Payer's Name and Email
Signature of Guardian/Parent
Date Completed
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
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