ENROL NOW - Yarra Heights Dance Academy

Students First Name

Students Last Name

Students Date of Birth

Does the student have Aboriginal or Torres Strait Islander origins?

Yes

Students Gender (Please list any preferred pronouns)

Primary Parent / Guardian / Contact Full Name

NB If student is 18yr or over, please enter student name here

Relationship

NB if student is 18yr or over, please enter "Student" here

Primary Phone

NB if student is 18yr or over, please enter student phone number

Primary Email

NB if student is 18yr or over, please enter student email

Mailing Address

Parent / Guardian 2 Full Name

Relationship

Secondary Phone

Secondary Email

What past dance experience does the student have?

Estimate Clothing Size at the end of this year (for costume purposes)

How did you hear about Yarra Heights Dance Academy?

I am an existing student

Word of mouth

Internet / Google search

Social Media (Facebook / Instagram)

Drove past / signage

Other

If other, please list below

Please refer to the class timetable and list below the code of the classes you wish to enrol in Eg 26TH1, 26F2

Please refer to the policies page of our website. Please indicate below that you have read and accept our terms and conditions:

I have read and accept the Enrolment Terms and Conditions

Please refer to the policies page of our website. Please indicate below that you have read and accept our code of conduct:

I have read and agree to the Code of Conduct

An enrolment fee of $45 must be paid to secure your place. Account Name: Yarra Heights Dance Academy Pty Ltd Bank: Westpac BSB: 033 149 Acct No. 495364

I agree to pay the enrolment fee prior to commencing classes

Parent full name (or student full name if 18yr or over)