Dirty Feet Outback Dace Festival - Workshop Participant Details Form
This form is compulsory for ALL participants taking part in workshop classes at Dirty Feet Outback Dance Festival 2025. Please submit one form per participant prior to taking part in dance classes.
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
D.O.B
*
-
Month
-
Day
Year
Date
STUDENT HEALTH INFORMATION
This form is to provide organisers and teachers with confidential health information about a student which may affect their full participation in some activities.
Does the student have any health conditions?
Asthma
Anaphylaxis
Diabetes
Epilepsy
Nil
Other
Does the student have any current or previous injuries that may affect their participation in dance classes?
No
Yes (please advise below)
What are the details of the injury?
WAIVER
Please sign this waiver prior to taking part in workshop classes 23rd to 27th September 2024.
I/We realise that participation in dance/acro classes and activities could involve some possible personal injury. Despite precautions accidents and injuries may occur. I/We assume all risks related to the use of any and all spaces used for Dirty Feet Outback Dance Festival hosted by Branches Performing Arts. I/We agree to release and hold harmless Branches Performing Arts, Amy Tinning, the teaching faculty, students and facilities used by all entities from any cause of action, claims, or personal demand now and in the future. I/We will not hold Branches Performing Arts responsible for any personal injury or personal property damage, which may occur on the premise before, during or after classes. Furthermore, I/we agree to obey by the class and facility rules and take full responsibility for my/our behaviour in addition to any damage I/we may cause to the facilities used by Branches Performing Arts.
*
MEDIA CONSENT
I acknowledge and consent to allow Dirty Feet Outback Dance Festival/Branches Performing Arts to use: photos and/or videos of my child/myself in publications (such as flyers/brochures), advertisements (such as newspapers or online ads), our studio’s website, or on social media sites (such as the event/studio’s facebook or instagram account). I understand that in some cases, my child and/or my name may be used.
*
Yes, I give media consent.
No, I do not give media consent.
ADULTS PILATES CLASSES
Did you know we have something just for Adults also?? Join Lonii Garnons-Williams for daily Pilates classes throughout the week. Pilates is a low-intensity muscle-strengthening workout that focuses heavily on building strong core muscles. Pilates — once a niche strength, mobility, and recovery technique for dancers — has evolved as a holistic way of introducing movement to your day. No previous experience required. REGISTER for classes by booking tickets below.
TICKETS
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1x Adults Pilates 3 Day class pass (Tues to Thurs) LATE REGO
$
85.00
AUD
Quantity
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10
1x Adults Pilates 1 Day class pass (Tuesday ONLY) LATE REGO
$
28.00
AUD
Quantity
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2
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5
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7
8
9
10
1x Adults Pilates 1 Day class pass (Wednesday ONLY) LATE REGO
$
28.00
AUD
Quantity
1
2
3
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5
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9
10
1x Adults Pilates 1 Day class pass (Thursday ONLY) LATE REGO
$
28.00
AUD
Quantity
1
2
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NOTE:
ALL TICKETS ARE NON-REFUNDABLE.
Submit
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