Trial Lesson Bookings

Trial Class Bookings

Welcome to Ellipsis Academy. Please complete the following form to register
Student Name 1

First NameLast Name
Student Name 2

First NameLast Name
Student Name 3

First NameLast Name
Date of Birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Student Address

Street Address

Street Address Line 2

CityState / Province

Post Code
Responsible Adult

First NameLast Name
Email Contact
example@example.com
Responsible Adult Address - If Different To Above

Street Address

Street Address Line 2

CityState / Province

Post Code
Emergency Telephone Number
Medical History/Current Diagnosis/Ongoing Injury
Please Enter N/A if this question does not apply to the student.
Where Did You Hear About Us?
Please Read The Below Statement Of Agreement

As a Member of Ellipsis Academy, The named responsible adult and named student understand and agree to the following terms.
1. Fees are to be paid promptly before the month end. Late payments will incur a 5% fee. Continuous late fees may incur expulsion from classes until the balance is paid.
2.Students are to wear the appropriate Sport/Dance wear in all classes - Uniform items are available to purchase when you are ready to do so.
3. Students and Responsible Adults are to treat the Ellipsis Academy Staff Members and other students with professional courtesy and respect. This includes all forms of communication - verbal, emails, social media etc.
4. Shoes such as Jazz shoes or Trainers must be worn for all Rock'n'Roll and Street aspects of classes.
5. Personal Belonging brought to classes by students are their responsibility and not that of the Ellipsis Academy Team.
6. Competitive Students will be asked to complete a season expectations contract before each season.
7. Students will have the opportunity to Compete, Take Examinations and Perform in Annual Theatre Showcases.
8. Students taking part in Annual Theatre Showcases will be asked to complete a cost and expectations contract each year.
9. Responsible Adults are expected to drop and collect students under the age of 12 from inside Buckland Community Centre before and after classes - Especially during the darker Winter Evenings.
10. Responsible Adults are expected to keep an open line of communications with the Ellipsis Academy Team - Preferably by email for both parties records.
11. Once the student has completed the trial booking, the Responsible Adult understands that the named student will automatically be enrolled to the Monthly Invoice System. Payments for fees at full price are to be paid weekly, fortnightly or monthly in cash or via BACS - Details for BACS will be included on all invoice emails.
12. Trial Bookings are not available for refunds.
13. The Responsible Adult understands they must inform the Ellipsis Academy Team via email of 'NON RETURN' once the Trial Bookings End to avoid being charged for following classes
13. Part A- Due to the nature of our activity. - Insurances, Staffing and such alike are pre-planned and paid for based on registrations for each class. This means we cannot deduct fees for missed classes. Should the student need to miss classes for illness, injury or hospitalisation that lasts longer that 6 weeks - broken bone etc. This policy will be void and deductions will be made to charges.
13. Part B- Classes missed due to holidays are deducted as such : Out of UK Holidays = 50% charge to complete insurance roll overs. Holidays in the UK = Full Charge.
Responsible Adult Signature
Almost There!

Please Select Your Trial Options

My Products

Full Session Trial - 4 Week Introductory Price

Class Styles - Disco Freestyle, Rock'n'Roll, Lyrical, Acro, Street Dance & Breakdance

£15.00 Quantity

Disco Freestyle & Rock'n'Roll Session - 4 Week Introductory Price

Class Styles - Disco Freestyle, Rock'n'Roll, Acro, Lyrical

£8.00 Quantity

Street & Break Dance Session - 4 Week Introductory Price

Class Styles - Street dance, Break Dance

£8.00 Quantity

Total

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Thank You For Completing Your Trial Booking !

Don't forget to click SUBMIT at the bottom of this Message.
You will receive a full welcome email from our Principal Teacher, Robine Cook in due course. This email will include your booked class information, trial dates & practice wear suggestions. We look forward to meeting you soon!

Ellipsis Academy Team.
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Trial Class Bookings

Please Read The Below Statement Of Agreement

Almost There!

My Products*

Thank You For Completing Your Trial Booking !

You will receive a full welcome email from our Principal Teacher, Robine Cook in due course. This email will include your booked class information, trial dates & practice wear suggestions. We look forward to meeting you soon!

My Products