Wiggles and Giggles Enrolment Form

Dancer Information
Dancer Full Name

First NameLast Name
Date of Birth*

MonthDayYear
Date
Which Level is your child enrolling in

Level 1 - ages 2-4yrs (your child must be turning 3 by June 30, 2026)Level 2 - ages 3-5yrs (your child must be turning 4 by June 30, 2026)
Which class is your child enroling in?

Medical & Emergency Information
Emergency Contact Name *

First NameLast Name
Relationship to Dancer*
Emergency Contact Mobile*
Please enter a valid phone number.
Does your dancer have any medical conditions? *
Please provide details:
Please list any allergies or medical conditions*
* Please provide all necessary details

Policies & Consents

Media Release
I give permission for BTQ to use photos/video of my child for promotional, archival, and educational purposes.*

YESNO
Conduct & Acknowledgements
Please read and confirm the following program expectations:
- I acknowledge that at least one adult is required to accompany and actively participate with my child in the Wiggles and Giggles Level 1 program at all times.
- All communication from BTQ will be delivered via email. I acknowledge and agree to check my email regularly for updates and notices.
- Fees paid to BTQ are non-refundable, except at BTQ’s discretion in exceptional circumstances.
- I acknowledge that BTQ’s Policies and Procedures will be provided to me and that I will be required to read and sign them prior to class commencement.
Please confirm your agreement:*

I have read and agree to the Program Conduct & Acknowledgements above.
Parent/Guardian Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Date

Enrolment Fee - $250
A non-refundable enrolment fee of $50 is required to secure your dancer’s place in Wiggles and Giggles.

This amount will be credited towards Term 1 fees.

Your enrolment is not confirmed until this payment is processed.

Enrolment Fee Payment *

Wiggles and Giggles Level 1Monday or Friday

$50.00AUD

Wiggles and Giggles Level 2Friday

$50.00AUD

Total

$0.00AUD

Thank You for Your Enrolment
BTQ will contact you shortly with the following:
- Term invoice
- Policies & Procedures Agreement (to be reviewed and signed)
Should be Empty:

BTQ - 2026 Enrolment