Christchurch Dance School Enrolment

Note – Places in our classes for term four 2020 are very limited

Student
Name*
First Last
Email*
Phone*
Address
Date of Birth
Style of Dance
- Ballet
- Jazz
- Pre School Dance
- Adult Class
Please list any medical conditions or behavioural/learning disabilities
We require this so we can ensure each dancer receives training suited to their specific needs.
Parent / Caregiver
Name*
First Last
Relationship to Dancer
Different details to student?
- Different Phone Number
- Different Email Address
- Different Address
Parent / Caregiver Phone*
Parent / Caregiver Email*
Parent / Caregiver Address*
Consent
I have read and agreed to the terms and conditions

Student