Online Enrolment Should you have any questions regarding enrolment for yourself or your child please contact us prior to completing this form. Parent/Guardian Name * First Name Last Name Parent/Guardian Email * Parent/Guardian Contact Number * (###) ### #### Parent/Guardian Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Student Information Students Name * First Name Last Name Date Of Birth * MM DD YYYY Name of School Attending and What Grade Any Medical Conditions or allergies? If so please list Class/Packing Selection Class Package Blush Rose Magenta Company Packages Little Stars (6&U) Gems (7-10) Silver (10-12) Gold (11-14) Platinum (Seniors) Elite (By Invitation Only) My child will be attending the following classes Jazz Acrobatics Tiny Tots Contortion Singing Aerial Tumbling Hip Hop Boys Only Tap Lyrical Ballet Stretch Competition Team Agreements I give permission for my child to be photographer by any member of staff 'Exclusive Dance' for promotional/archival purposes and/or published to the school's website. * I agree I do not agree By Submitting this enrolment form you agree and verify that the enrolment form information is correct and also confirm that your above stated child, is able to participate in their nominated dance classes, and that during these classes you are aware that injury can occur, and you are willing to endure any costs associated with the injury. * I agree I do not agree Thank you! One of our team will be in contact soon to confirm enrolment. Should you have any questions please do not hesitate to reach out.
