Enrolment

Helen O'Grady Drama Academy - Enrolment Form
Please enter students from the same family on different forms.
Enrolment Type*
Please select your studio of choice from the list below
Region*
Bay of Plenty*
Manawatu*
Wellington*
Child's Name*

First NameLast Name
Date of Birth*

DayMonthYear
Age*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Post Code*
Home Phone Number*

Area CodePhone Number
Mobile Number

Area CodePhone Number
Emergency Number. Crucial, so that we can contact you*
Please Specify the number to call in an Emergency*
Gender*

MaleFemale
Name of School*
Year at School*
Email Address*
Email address is important to receive newsletters and important correspondence.
Mother's Name or Primary Caregiver*
Partners Name (optional)
How Did You Hear About Helen O'Grady Drama Academy?*

RadioNewspaperSchool FlyerWord of MouthWebsiteOther
Please Specify "Other"
Please list any physical, behavioural or learning difficulties experienced by your child. Enter NIL if not applicable*
Describe any medical issues we should know about. Enter NIL if not applicable.*
Parent/Caregiver Declaration

By clicking Submit below you agree to the following statements.

1) I acknowledge acceptance of this enrolment is at the discretion of Helen O'Grady Drama Academy.

2) I understand I will be provided with a copy of the Fee Policy and Classroom Policy which are part of the acceptance of this enrolment.

3) I understand payment of fees is required to complete this enrolment.

4) I give permission for photos of my child, taken during class, to be used in advertising or promotional material for the Helen O'Grady Drama Academy.
Should be Empty:

Helen O'Grady Drama Academy - Enrolment Form