Coastal Dance Enrolment Form 2016

Dancers Name *

First Name Last Name

Date of Birth *

Parent #1 Name *

Parent #2 Name

Address *

Street Address

City	State / Province
Postal / Zip Code	Country

E-mail *

Phone Number *

Area Code Phone Number

Level *

Tiny Tots (3 Years) Pre-Junior A (4 Years) Pre-Junior B (5 Years) Junior A (6 - 9 Years) Junior B (10 - 12 Years) Intermediate (13 - 14 Years) Senior ( 15 Years +)

Classes

Terms & Conditions *

I hereby give Coastal Dance permission to use any still and/or moving image being video footage, photographs and/or frames depicting the student named above, whilst performing with Coastal Dance for any of the following uses: advertisements, marketing, leaflets, or any other use such as for training, educational or publicity purposes or use on our website. I, the legal parent/guardian accept and understand that appropriate physical contact may be necessary within the dance class and hereby give permission for any teacher from Coastal Dance to do so. Competitive pupils may only attend Coastal Dance as a sole competitive representative. Pupils will not be allowed to attend different competitive studios. Invoices are sent at the commencement of each term and need to be settled by the due date. Payment plans can be discussed. Failure to pay will result in pupils sitting watching until payment is received. Private lessons payments should be given to the teacher at the start of the lesson. Legal action will be taken if invoices are not settled. If you are unable to attend your class, a text or email would be appreciated. Pupils arriving over 10 minutes late for a class (unless previously stated) will be required to watch the class due to missing the warm-up and therefore contradicting our health and safety policy. Bullying or Cyber Bullying will not be tolerated within our school or social network under any circumstance. If a situation arises in class or outside class times the principal would like to be informed of this and relevant actions will be taken. The information provided in this form will be treated confidentially and will only be used for administration purposes by Coastal Dance. No information will be released to any external parties.

Referred by