ENROLMENT FORM 2014

Please copy and paste the following form into a new email and send to amy@urbandance.co.nz with Enrolment in the subject box or alternatively you can print the Enrolment form and post to Studio712 Dance Centre, PO Box 109451, Newmarket 1149. Please ensure all sections are completed.

 

STUDIO712 DANCE CENTRE ENROLMENT FORM 2014

 

STUDENT INFORMATION

Name:
Address:
Home phone:
Mobile:
Email:
Date of Birth:

PARENT/CAREGIVER INFORMATION

 

Name:
Home phone:
Work phone:
Mobile:
Email:

ALTERNATIVE CONTACT

 

Name:
Relationship to student:
Home phone:
Work phone:
Mobile:

Classes to be enrolled in

 

Style
Grade
Day
Time

 

Has the student had any previous dance experience?

Please list any injuries or medical conditions the student has.

 

Is the student on any medication? What?

Have you read and understood all terms and conditions?

 

All contact from the studio to Parents/Students will be via email. Please say if you would prefer it through post or given out during class time.

 

Signed:
Date: