2021 KREATIONZ TRIAL BOOKING FORM

MAIN ACCOUNT HOLDER DETAILS

The Main Account Holder is the person responsible for:
- Paying fees
- Receiving information
Account Holder Name *

First Name Last Name
Relationship to Student *
E-mail *
Mobile *
Postal Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

STUDENT 1 DETAILS
Student 1 Name *

First Name Last Name
Gender *

Female Male
Date of Birth *

Day Month Year
Date
Current Age *
Please list any allergies, medications or medical conditions, including action to be taken (if applicable)
STUDENT 2 DETAILS (if applicable)
Student 2 Name

First Name Last Name
Gender

Female Male
Date of Birth

Day Month Year
Date
Current Age
Please list any allergies, medications or medical conditions, including action to be taken (if applicable)
STUDENT 3 DETAILS (if applicable)
Student 3 Name

First Name Last Name
Gender

Female Male
Date of Birth

Day Month Year
Date
Current Age
Please list any allergies, medications or medical conditions, including action to be taken (if applicable)

MEDICAL INFORMATION AND CONSENT
If Student 1, Student 2 or Student 3 has an Anaphalaxis or Asthma Management Plan, or any other relevant documentation please attach it here

Browse Files

Cancel of
Medical Emergency Acknowledgement *

I acknowledge that in case of medical emergency, an ambulance will be called for my child/myself, if necessary.
Do you consent to Kreationz staff giving your child/ren a bandaid if necessary? *

Yes No
STUDIO LOCATION
Please select a studio location for your trial *

Emerald Ferntree Gully Yarra Valley

TERMS AND CONDITIONS AND COVIDSAFE PLAN

In order to commence classes with Kreationz, the COVIDSafe Plan and Terms and Conditions must be read, understood and agreed to.

The COVIDSafe Plan can be downloaded here and the Trial Booking Terms and Conditions can be downloaded here.
Please sign here to indicate your agreement to the COVIDSafe Plan AND Terms and Conditions *

Clear

ONE STUDENT - Mainstream Trial One Week Pass $ 16.36 AUD

TWO STUDENTS - Mainstream Trial One Week Pass $ 32.73 AUD

THREE STUDENTS - Mainstream Trial One Week Pass $ 49.09 AUD

Subtotal $ 0.00 AUD Tax $ 0.00 AUD Total $ 0.00 AUD

2021 KREATIONZ TRIAL BOOKING FORM - MAINSTREAM CLASSES