REGISTRATION FORM 2021
Below is the registration for 2021. With this form you accept the terms and condition as stipulated in the information leaflet. For more info go to our website www.bounceschoolofdance.com
Student Information
Student name
*
First Name
Last Name
Class attending
*
Class name and time (check information document for class name and time) - eg. junior hip-hop 3:00pm
New dancer or previous dancer
*
Please state here
Birthdate
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Any specifics to be aware of your child
Anxiety, allergies, etc
Parental Guardian Information
Parent name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Billing Information
Name of Person responsible for bill payment
*
Contact information of person providing payment
*
Email
Phone Number
Can any photos of your child be used on our website or other advertising material for Bounce School of dance
*
Yes/No
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Submit
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