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2023 VERCHOVYNA SCHOOL ENROLMENT FORM
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* Indicates required question
Dancer Details
Surname
*
Your answer
Given Name - Dancer 1
*
Your answer
Date of Birth - Dancer 1
*
MM
/
DD
/
YYYY
Mobile Number - Dancer 1
Your answer
Given Name - Dancer 2
Your answer
Date of Birth - Dancer 2
MM
/
DD
/
YYYY
Mobile Number - Dancer 2
Your answer
Given Name - Dancer 3
Your answer
Date of Birth - Dancer 3
MM
/
DD
/
YYYY
Mobile Number - Dancer 3
Your answer
Address
*
Your answer
Telephone
*
Your answer
Email #1
*
Main email used for Verchovyna correspondence
Your answer
Email #2
Your answer
Are you a current CYM Financial Member?
To receive the CYM member discount rate you must be a CYM financial member.
Yes
No
Clear selection
NOTE
Completion of all fields is required including one suitable email address. Email is used regularly for Verchovyna communications. Please notify Verchovyna Administration of any changes to contact details throughout the year by emailing
info@verchovyna.com.au
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