IPA Book a Trial Form 2026

Book a Trial Form 2026
Students Name

First NameLast Name
DOB

MonthDayYear
Date
Parents Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Medical Conditions (List and Advise of Plan)
How did you hear about us?
Have you danced before?
Ballet
Which Level are you?
What styles would you like to take? (Petite - Senior ONLY) Please refer to the timetable on our website to help answer this question.
Pre School Program ONLY - What day would you like?
Pre School Program ONLY - Ready Set Ballet (30mins)
Pre School Program ONLY - Ready Set Dance (45mins)
Date you would like to trial (if multiple days, pick the first day) Term 1 starts 27/1/2026

MonthDayYear
Date
Health and Safety - By agreeing you understand that although IPA takes all reasonable care in the conduct and safe dance of its classes that personal injury can occur and Influence PA and its staff will not be held responsible.
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