STUDENT INFORMATION

First name

Last name

DOB

Age

Dance experience

MEDICAL INFORMATION

Does your child suffer from any medical conditions that NADC should be aware of? YesNo

Does your child take regular medication NADC should be aware of? YesNo

Does your child have any allergies? YesNo

Does your child have any reoccurring injuries? YesNo

If you have answered YES to any of these questions, please specify details.

CLASS REGISTRATION
BALLET (Rec.)Ballet (Exam)TapJazz / Hip HopLyrical / ContemporaryAcro DanceCheerleadingStretch & ConditioningPerformance GroupPrivate lesson

PARENT / GUARDIAN INFORMATION

Parent 1

Parent 2

Street Address

Suburb

Post code

Email address

Contact No.

Emergency Contact Name & No.

Additional Information

Would you prefer to pay $20.00 trophy leve or fundraise? Pay the leveFundraise

Would you like to contribute throughout the year to your costume fund? YesNo

If selected YES, please specify frequency and amount

DISCLAIMER

I understand that NADC classes may include, without limitation, dancing with props, stretching, barre work, across the floor combinations, dance routines in the centre, and other related activities, as well as acrobatic/tumbling learning & combinations. I further understand that all of the activities of NADC classes will involve some degree of risk of strain or bodily injury. I will not hold NADC liable for any personal injury to any persons while on premises, nor will I hold NADC responsible for any personal property losses.

It is noted that at times, photos or videos of my child in class, rehearsals and/or performances may be used for promotional purposes by NADC. I hereby give permission for my child’s image/video to be used by NADC in the public domain.

I acknowledge that I have received the NADC 2017 Student Handbook and agree to adhere to all the content stated therein including and not limited to: Studio Policies, Tuition & Payment Information, Dress Code etc.

I agree to be responsible for reading studio correspondence and respecting deadlines, when applicable. I hereby acknowledge that I have read the statements above and agree to participate accordingly.

Please tick I agree