Danceworks Sydney Enrolment Form

Student Registration Form

Fill out the form carefully for registration
Parent Name:*

First NameLast Name
Student Name:*

First NameLast Name
Birth Date*

DayMonthYear
Parent/Guardian Email:*
example@example.com
Parent/Guardian Phone:*
Format: (000) 000-0000.
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Siblings Already Enrolled:

First NameLast Name
Courses*
Please list any medical condition, disability or illness we should be aware of:
I agree to pay all invoices within 2 weeks of commencement of each term? *

Yes
I consent that teachers can physically place child in dance class? *

Yes
I understand I am responsible for my child before and after class and that supervision is not provided outside of the dance class times*

Yes
I agree to images or videos of my child to be used in publicity material?*

YesNo
Name of Person completing the form:*

First NameLast Name
Should be Empty:

Student Registration Form