Dance N Dazzle Enrolment Form

Student Name *

First NameLast Name

Birth Date

Date

Present Age*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Email*

example@example.com

Parent Name/s*

Please List any Medical Conditions - (e.g. Asthma)

Emergency Contact Person*

Phone Number*

Please enter a valid phone number.

I give my child permission to be Photographed/Filmed for the Studio Website, Social Media or Newspaper*

Yes

How did you hear about us?

Is this a New or Returning Student?*

NewReturning

My child will be participating in the following classes:-*

DND Policies and Procedures*

I have read, understood and accept the policies and procedures for Dance N DazzleI acknowledge that all tuition fees must be paid by the due date stated. Late or overdue payments may incur a late fee. Continued non-payment may result in suspension of classes until the account is brought up to date.Personal Risk and Injury - All dance classes can involve the risk of personal injury. Whilst Dance N Dazzle takes all reasonable care in the conduct of all its classes, it accepts no responsibility for injury or loss caused during classes or whilst participants are at or near the dance studio. You are responsible for ensuring that you/your child are medically fit for the class and during class you must take care of your own personal safety at all times.Teaching - Dance sometimes requires teachers to assist in creating the correct lines and movements. I understand that the staff at Dance N Dazzle are practical teachers and will move and correct my child's body positions, placement within routines and lines and movements in a hands-on.Agreement - I have enrolled my child into Dance N Dazzle. I have read the information brochures and do agree to abide by the rules and conditions set out by the studio, with the understanding that should any problems arise, I will contact the owner immediately.