Raz Studios Enrolment Form

Registration Form

Please fill in the form below.
Parent/Guardian Information
Parent 1 Name*

First NameLast Name
Parent 1 Mobile*
Format: 0000 000 000.
Parent 2 Name

First NameLast Name
Parent 2 Mobile
Format: 0000 000 000.
Address*

Street Address

Street Address Line 2

CityState

Post CodeCountry
Home Phone Number
Format: 0000 0000.
Best E-mail for communication*
Person responsible for paying fees and other associated costs

Parent 1Parent 2Other
Student Information
Student Name*

First NameLast Name
Student Gender*

FemaleMale
DOB*
DD/MM/YYYY
Address*

Same as AboveOther
School Attending
Name of School
Please indicate if your child has had any experience in dance before. If so, please list what styles, levels, exam grades completed.
Emergency Contact Details
Emergency Contact Name*

First NameLast Name
Relationship to Student*
Aunty/Uncle/Family Friend
Phone Number*
Format: 0000 000 000.
General Information
Does your child have any medical conditions?*

NoOther
Does your child take any regular medication?*

NoOther
Does your child have any dietary requirements?*

NoOther
Does your child have any diagnosed conditions that Raz Studios should be aware of?*

NoOther
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge and should any of the provided information change I agree to forward it to Raz Studios.*

Yes
I hereby give permission for my child’s image to be taken and used by Raz Studios for promotional purposes in public domains.*

YesNo
I have read and understand the terms and conditions as outlined in the Raz Studios Policy and Information Booklet. I am aware that all fees are payable by week 2 of each term and failure to do so will result in administration fees and my child not being able to participate in classes. I acknowledge that partaking in Dance activities comes with associated risk of potential injury and I agree to waive any and all claims of liability against Raz Studios in the event of injury, permanent damage or death. In the event of an accident I hereby give Raz Studios staff permission to provide medical attention where deemed necessary. I also acknowledge that the end of year photo day and dress rehearsal are all compulsory events for all students enrolled at Raz Studios whom wish to partake in the annual concert.*
Signature*

Please sign in the space provided above
Please verify that you are human*
Should be Empty:

Registration Form

Parent/Guardian Information

Student Information

Emergency Contact Details

General Information

Disclaimer and Signature