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GC Physie and Dance Registration 2024
Contact: Hayley Murray 0400220774
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* Indicates required question
Email
*
Your email
Parents/Guardian Name
Your answer
Dancer 1 Full Name
*
Your answer
Dancer 1 DOB (D/M/Y)
*
Your answer
Dancer 1 Class attending (Age on 31st Aug 2024)
*
Choose
Tiny Tots
5-6 Years
7-8 Years
9-12 Years
13-15 Years
16 years / Intermediates
Open Elites
Ladies
Dancer 2 Full Name
Your answer
Dancer 2 DOB (D/M/Y)
Your answer
Dancer 2 Class attending (Age on 31st Aug 2024)
Choose
5-6 Years
7-8 Years
9-12 Years
13-15 Years
16 years / Intermediates
Open elites
Ladies
Dancer 3 Full Name
Your answer
Dancer 3 DOB (D/M/Y)
MM
/
DD
/
YYYY
Dancer 3 Class attending (Age on 31st Aug 2024)
Choose
5-6 Years
7-8 Years
9-12 Years
13-15 Years
16 years / Intermediates
Open Elites
Ladies
Dancer 4 Full Name
Your answer
Dancer 4 DOB (D/M/Y)
MM
/
DD
/
YYYY
Dancer 4 Class attending (Age on 31st Aug 2024)
Choose
5-6 Years
7-8 Years
9-12 Years
13-15 Years
16 years / Intermediates
Open Elites
Ladies
Email
*
Your answer
Address
*
Your answer
Mobile Phone
*
Your answer
Emergency Name and Mobile
*
Your answer
Any allergies/illness/disabilities? Anything else you feel our teachers should be made aware of?
*
Your answer
What days will you attend?
*
Wednesday
Saturday
Both
Required
Do you give permission for photos of members to be used on GC Physie and Dance Club advertising material including website?
*
Yes
No
In the case of emergency, do you give permission for our teachers to call 000, and perform first aid on the member if the situation requires?
*
Yes
No
Required
TERMS AND CONDITIONS 2024:
I HAVE READ AND AGREE TO ABIDE BY THE TERMS AND CONDITIONS OF GC PHYSIE AND DANCE CLUB INC.
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No
Required
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