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Student Name

Student Date of Birth

School Year

Home Address

Suburb

Postcode

Home Phone

Mobile

Email

Guardian 1 Name and Mobile

Guardian 2 Name and Mobile

Allergies and/or Medical Conditions (Please describe in order to help us when working with your child)

Please list the class/classes that your child/children would like to participate in - Please include Class, Day, Time. (For Example: Pre Ballet, Wednesday 3:30pm)

Waiver and Consent Agreement/Terms and Conditions

Participation in any Dance for Life! activity and use of any recreational facilities involves a risk of accidental injury despite all safety precautions. Having been informed of the activities conducted by the Dance for Life! School of Dance, I as an individual or as a parent or guardian of the participant named herein, assume all risks and hazards incidental to the activities, and release from responsibility and agreed to indemnify and hold harmless Dance for Life! its officers, directors, independent contractors, volunteers and all employees for any illness or injury to me or my children or family members occurring during his / her / our participation in any activity or use of any recreational facility at or conducted by Dance for Life!

I confirm I have read the ‘2018 DfL Terms & Conditions’.

I understand that a $16.50 Registration Fee is to be paid when this enrolment is confirmed by Dance for Life.

I understand that if Term Fees are late, a $16.50 Fee will be added weekly until Fees are finalised.

I understand that there are no refunds on fees if my child misses class/es for any reason - Students are encouraged to come to another class to make-up for missed lessons.

Media/Photo Release: Throughout the year Dance for Life! may occasionally use the student’s name, photographic and/or video images for use on our website, brochures, newsletters, newspaper advertisements, Facebook and other Social Media. Some of this material may be used as promotional material or as a teaching aid.

Please select one option:
I doI do not allow for photos and/or video footage of my child/self to be taken and published on written and electronic media.