ENROLMENT FORM 2022
Please submit this completed form and pay the membership fee by your student's second class. Thank you
Sign in to Google to save your progress. Learn more
Student's Name *
Date of Birth *
Parent's Name *
Email Address *
Address *
Phone *
Alternate Phone
Previous Dance History *
Health Comments
Classes to Be Enrolled in *
Required
Do you wish to participate in exams? *
Required
Do you wish to participate in eisteddfods? *
Required
Do you wish to participate in our end of year concert? *
Required
Please be aware that if you have ticked that you wish to be involved in any of the above, you may be required to purchase additional uniforms, shoes and costumes as a condition of entry.  Do you agree to these conditions? *
Required
Do you give permission for PMAD to use your child's photos in our newsletters, website, advertising and social media? *
Required
Parental Involvement - Can you assist with any of the following?  All parents will be asked to help with concert duties at the end of the year.
I hereby give permission for my child, or myself (if 18 years or over) to participate in dance classes.  I fully understand that this is at my/my child's own risk, and that while all care will be taken with students, no responsibility will be accepted by the school or those involved with the school.  I understand that a late fee of $80 will apply to all overdue accounts.  In the event of a medical emergency, and where a parent cannot be contacted, I authorise the dance school to seek medical advice/attention/give first aid for my child at a hospital, medical centre, or at the studio.  Please sign below to acknowledge and accept these terms. *
Date *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms