Re-Enrolment Form

Re-Enrolment Form

Before completing the form please make yourself familiar with our Terms and Conditions, Class Pricing & Timetable as listed in our Handbook.
Full Name

First Name Last Name
Date of Birth

Month Day Year
Date Date Picker Icon

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

Area Code Phone Number
Email
example@example.com
Emergency Contact Update
Name

First Name Last Name
Phone Number

Area Code Phone Number
Relationship to Student
Allergies/Medical Conditions
Preferred Classes

Please tick the box
Classes

Ballet (Casual Class) Ballet RAD Exam Class Jazz Tap Contemporary Performance Team/Eisteddfod Groups Girls/Boys Hip Hop Stretch AcroDance Highland Pointe Ballet Theory
Do you wish to participate in RAD Classical Ballet Exams? (Please note exams are an additional cost and your child will need to attend a minimum of two ballet classes a week to complete the exam.)

Yes No
Do you give permission for your child to be photographed/videoed during class/rehearsals and at times added to our website/social media gallery or newsletters?

Yes No
Fees
1. You will be billed per term and payment, in full, is expected two weeks after the date of invoice. If payment is not received by this time you will receive a $30 late fee that will be applied to your invoice.
2. Refunds for missed classes are not offered.
I have read the TDF Handbook

Yes No
I agree to the Terms & Conditions and Fee Schedule in the Handbook

Yes No
By checking 'I Agree' below and submitting this form, you, the Parent or Guardian of the above student, agree to release "The Dance Factory", including instructors and assistants from liability for any and all injuries which may occur while training, practicing, performing, or during any studio event or activity. You also agree that you are responsible for health and accident insurance and any medical costs incurred due to injury. You give permission for emergency medical transportation and treatment of your student(s) at your expense should the need arise. You also give your permission for the teachers at "The Dance Factory" to use physical contact while teaching, E.g. assisting with posture.

I Agree I Disagree
Signature

Clear
Full Name

First Name Last Name
Date

Month Day Year
Date Date Picker Icon
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

Re-Enrolment Form

Emergency Contact Update

Preferred Classes

Fees