Students Name:


Date of Birth: (dd/mm/yy)

Parent / Caregivers Name:

Postal Address:

Home Phone:

Mobile Phone:


Please list any Medical Conditions:

Class enroling in:

Class Level:

Day Attending:

Payment Options: Fees to be invoiced termly

How did you hear about Danceworks?

Permission to use your child's photo used in Danceworks advertising material:

By enrolling your child you are agreeing to our Terms & Conditions

By typing your name in this box you release Danceworks Ltd of any liability for accident or injury that may occur while attending dance classes.

Thank you very much from the staff at Danceworks Ltd.