2025 Spring Workshop Registration

TUES 7, WED 8, THURS 9 OCTOBER 2025

Dubbo Ballet Studio, 13 Douglas Mawson Rd, Dubbo
3 days of stimulating dance classes for students 7 - 18yrs!

Open to all dance students across western NSW.
STUDENT NAME

First NameLast Name
DATE OF BIRTH

DayMonthYear
Date
E-MAIL
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Dance School Currently Attending
Age Group for Workshop: (Based on age at Dec 31, 2025)

TERMS AND CONDITIONS
MEDICAL CLEARANCE

In order to gain the maximum benefit in all forms of dance, physical contact is required at times to enhance correction. Students with medical conditions should obtain appropriate medical clearance before commencing class. Although every care is taken, students participate at their own risk.
Tick One:
PAYMENT

You have the option of paying the full amount upfront, or a non refundable deposit of $100.00 to secure your spot. Full payment needs to be received by Friday 19 September 2025, or your place may be forfeited. Partial refunds may be permissible before 19 September. No refunds will be given for withdrawal after Friday 19 September 2025.
Agreement:

I fully understand and agree to the above. I take responsibility for the full payment of fees owed for this student.
Parent / Guardian Name:

First NameLast Name
Tick One:
PAYMENT - Please choose 1 option:
prevnext( X )
Non Refundable Deposit
Balance payable by Friday September 19, 2025

$100.00 AUD Quantity



Junior Full Payment
7-11yrs

$400.00 AUD Quantity



Senior Full Payment
12 - 18yrs

$475.00 AUD Quantity



Total

$0.00 AUD
Should be Empty:

TUES 7, WED 8, THURS 9 OCTOBER 2025