Christchurch Dance School Enrolment

Student
Dancer's Name*
First Last
Preferred Contact Email*
Preferred Contact Phone*
Address
Date of Birth
Style of Dance
- Ballet
- Jazz
- Pre School Dance
- Adult Class
- Contemporary
Please list an information that will assist us in giving your dancer the best experience possible.
i.e, medical conditions, learning disabilities, preferred pronouns etc.
This information will be kept confidential.
Parent / Caregiver
Name*
First Last
Relationship to Dancer
Different/alternative emergency contact?
- 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