DWDA Enrolment Form
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Email *
Parent/Caregivers Full Name *
Child/Students Full Name *
Date of Birth *
MM
/
DD
/
YYYY
Phone Number *
Address *
Emergency Contact Name and Phone Number *
List any medical conditions/learning difficulties that we should know about.  (Put NONE if there are none) *
List any previous or current injuries that we should be aware of.  (Put NONE if there are none) *
Class name and times that you wish to enrol in
Class Days
Prompt payment *
By enrolling this student you accept responsibility for payment of tuition fees. You are aware that invoices will be sent out and fees are payable in full by second week of student start date.
Required
Photography and Video Permission *
As a condition of enrolment your child may be videoed or photographed during classes.  This may be used in publicity for studio promotions.  No personal videos or photos are to be taken of any student during class time unless approved by the Academy.
Required
Waiver Statement *
You understand and agree that DWDA will not be liable in any way for accidents or injuries sustained through participation in classes or related activities. Unless notified to the contrary, it is understood that the parent/guardian grants permission for the staff of DWDA to authorise any emergency medical care deemed necessary whilst on site.
Required
How did you hear about Denise Walker Dance Academy *
Required
Comments
Terms and Conditions/Code of Conduct *
By enrolling with us you agree to abide by our terms and conditions and our code of conduct.
Required
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