ENROLMENT FORM

STUDENT NAME (required)

DOB (required)

SCHOOL YEAR (required)

ADDRESS (required)

PHONE (required)

EMAIL (required)

PARENT/GUARDIAN NAME (required)

PARENT/GUARDIAN NUMBER (required)

EMERGENCY NAME (required)

EMERGENCY NUMBER (required)

DOES THE STUDENT HAVE ANY INJURIES, DISABILITIES, MEDICAL CONDITIONS OR ALLERGIES THAT STUDIO A NEED TO BE AWARE OF? PLEASE SPECIFY.

DO YOU GIVE US PERMISSION TO USE YOUR CHILD’S PHOTOGRAPH / VIDEO FOOTAGE FOR ADVERTISING AND SOCIAL MEDIA
 Yes No

CLASS SELECTIONS
 Shooting Stars Rising Stars Ballet Pilates Jazz Actors Studio Singing Tap Contemporary Boys only Musical Theatre Irish Dancing Acro Show Squad DJ Jazzy

WOULD LIKE PRIVATE TUITION?
IF SO, PLEASE ADVISE WHICH STYLE YOU WISH TO BE COACHED IN, AND WHETHER YOU WOULD LIKE A SOLO CHOREOGRAPHED FOR YOUR CHILD FOR COMPETITION WORK.

PLEASE OUTLINE ANY DANCE, DRAMA OR SINGING EXPERIENCE.

HOW DID YOU HEAR ABOUT STUDIO A? (required)
Social MediaAdvertisingWord of MouthOther

Do you agree to our Terms and Conditions?
 Yes

This Enrolment attracts an Enrolment Fee. This will be added to your first invoice. Our administration team will process your Enrolment once payment has been received and you will be added to our email system.