West End Dance Enrolment Form 2019

Dancer Details
Desired Classes

*must enrol in 2 ballet classes if you wish to sit ballet exams

Class Ages Time
Contact Details for Correspondence & Billing
Emergency Contact 1 OR Primary Guardian
Emergency Contact 2 OR Secondary
Health

Does the dancer have any of the following health conditions?

Marketing

From time to time, we might use the dancers image for our social media, website or flyers. We will always keep the dancers name confidential. If you would like to opt out, please tick below.

How did you hear about us?

Pay Enrolment