WAPA Enrolment Form
Please fill out the following enrolment form to enrol for class at WAPA
Students Name
*
First Name
Last Name
Students Date of Birth
*
-
Month
-
Day
Year
Date
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Number
*
Emergency Contact Relation to Student
*
Address
Street Address
Street Address Line 2
City
Country
Postal / Zip Code
Classes Wishing to Enrol ($10 per class)
*
Junior HIP HOP (Mondays 4.15pm - 5.00pm) - Colette Wilson
Junior Contempary Mondays 5.00pm - 5.45pm) - Colette Wilson
Senior Hip Hop (Mondays 5.45pm - 6.30pm) - Colette Wilson
Senior Jazz (Monday's 6.30pm- 7.15pm) - Colette Wilson
Junior MUSICAL THEATRE(Friday's 5:00pm-6:00pm)-Colette Wilson
Senior MUSICAL THEATRE(Friday's 6:00pm-7:00pm)-ColetteWilso
Baby Ballet age 3+Years ( Saturdays' 8.30-9am)Colette Wilson
Baby Ballet Age 4-5 Years (Saturday's 9.00-9.30am)-Colette Wilson
COF Circle Of Friends 7+ Years (Tuesdays 4:30-6pm)-Colette Wilson
Adult Hip Hop Fitness (Tuesday's 6-6:45pm)- Colette Wilson
Mini Hip Hop 4-6 Years (Monday's 3.30pm-4:15pm)- Colette Wilson
Email Address
*
example@example.com
Please list any Medical Conditions or any Ongoing Injuries (N/A if needed)
*
Please list any previous dance experience
I consent to WAPA using images and videos of said student for marketing, website and social media purposes
*
Yes
No
Enter the message as it's shown
*
Email
example@example.com
Submit
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