Accent on Dance Enrolment Form

Please fill in the student(s) details below. After the form has been digitally completed, press the print button. Bring this completed signed form to registration day or Fax to (02) 4572 7290.

Are you a
First Name: Surname: DOB:
Siblings (if Enrolling)
First Name: Surname: DOB:
First Name: Surname: DOB:

Address:



Suburb:





Postcode:





Home Phone Number: Student's Mobile:
Mother's Name: Father's Name:
Mother's Phone: Father's Phone Number:
Mother's Occupations: Father's Occupation:
E-mail Address: Student's Dance History:
Style of Dance student/s is enrolling: (please tick) Ballet - RAD Jazz Modern Tap Hip Hop

Does the student have a medical condition/s, which the teachers should know about? (Injury, physical disability e.g. sight or Hearing loss, or illness suffered e.g. Asthma, Epilepsy, Diabetes etc.) Please list:

CONDITIONS OF ENROLMENT:
  1. Tuition fee will be paid by the due date of each term week 2 & is non-refundable.
  2. Registration fee to be paid at registration day and is non-refundable after Term 1.
  3. Babies & Pre-primary students Registration fee is due Registration Day and is non-refundable after April 30th.
  4. If hours change the Principal is to be notified in writing either by email or letter otherwise full term fees will be charged and an administration fee of $30.00.
  5. Each term an administration fee of $30.00 will be charged. This fee will be waivered when term fees are paid by the due date.
  6. Your place will be only held if fees are paid for each new term by the due date.
  7. All care according to the "Code of Ethics of Dance Teachers" will be taken by the Academy, but no responsibility for injury or loss to person or property howsoever caused and without limiting the generality of the a foregoing damage or injury resulting from or caused by any negligence of the principal, or other employees of the said "Accent on Dance".
  8. No responsibility will be taken for students before or after the class start & finish times. Children must be supervised out of class hours by parents/guardians.
  9. Permission is given to seek First Aid or Medical Attention if required.
  10. Permission is given to photograph film, or video students to be used for studio publicity or memorabilia.
  11. We will try to the best of our ability to assist the students but Accent on Dance reserves the right to cancel a student's enrolment or continued attendance at the Dance School without providing any reason.
I agree to the conditions of enrolment: (Please Select) Yes / No

Name of Parent/Guardian: Signature: ____________________

Date:

 

 

** Registration Fee must be included with this Enrolment **

PLEASE WRITE AMOUNT IN THE BOX/ES FOR THE ITEM/S YOU ARE PAYING

Registration Fee:

(Refer Fee Structure)

$

 

Term:

 

$

 

Exam Fee: $ Uniform Order: $
TOTAL AMOUNT PAYING $
PAYMENT OPTIONS:


Visa / Credit Card

 

 

__________ __________ __________ __________

 

Exp: ____ /____
Amount: $    

 

Name on Card:

 

____________________

 

Drivers Licence No:

 

____________________
    (If paying by Credit Card)
Signature: ____________________        

 

Please print and sign the completed Registration Form, then bring this form to Registration Day or Fax to (02) 4572 7290.