Student audition nomination form

2023 Riverina Wagga Wagga Primary Dance Ensemble

The Riverina Wagga Wagga Primary Dance Ensemble is an auditioned dance ensemble for talented dance students in Year 4 to Year 6 from public schools in Wagga Wagga and surrounding areas to develop their skills above and beyond the school level.

Ensemble members are required to attend weekly rehearsals at Wagga Wagga High School, Currie Hall on Mondays from 3:45 pm - 5:00 pm

Additional rehearsals may also be required in the lead-up to performances.

Please submit this nomination form by Friday 10 February 2023 (Term 1 Week 3)  

Audition details (Round 1) Date: Monday 13 February 2023 Where: Wagga Wagga High School, Currie Hall Registration: 3:30 pm Audition time: 4:00 pm to 6:00 pm

Call back audition details (Round 2)
Where: Wagga Wagga High School, Currie Hall
Registration: 3:30 pm
Audition time: 3:4 5pm to 5:00 pm

Enquiries

Hilary Hill - Ensemble coordinator (Red Hill Public School)
hilary.measday2@det.nsw.edu.au 
02 6931 1263 


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电子邮件地址 *
Student Details
Student name *
Student school *
Student Year group in 2023  *
Student DOB *
年
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月
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日
Student gender  *
Student home address, suburb and postcode
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Are you of Aboriginal or Torres Strait Islander origin?
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Is a language other than English spoken at home? If yes, please indicate the language spoken at home next to 'other'.
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Please list any educational modifications or special provisions required to meet the learning needs of your child
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Parent / caregiver details and consent 
Parent / caregiver name
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Parent / caregiver relationship to student
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Parent / caregiver contact number
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Parent / caregiver email
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I acknowledge that this event/activity is required to be held in accordance with any current NSW Health COVID-19 Public Health Orders and the NSW Department of Education’s policies and procedures. I acknowledge and accept that there is a risk that my child may be exposed to COVID-19 whilst attending and participating at this event. I confirm that my child will not attend if displaying any symptoms of illness, and/or if directed to isolate under public health orders.
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Student medical details
In the event or Illness, when it is impracticable or impossible to communicate with me, it is understood that the teacher in charge will arrange such medical or surgical treatment as may as be deemed necessary.

Required medication will be provided the school in a sealed envelope, in the original package from the distributing pharmacy, clearly labelled with the student's name and the dosage that is required. Only those students who have a condition requiring their medication to be with them (eg insulin pump, epi-pen) and have the approval of their principal and the program coordinator may carry medication with them.
Emergency alternate contacts details 
Other than parent/carer listed above
Name of emergency contact 
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Emergency contact - relationship to student
 *
Emergency contact - mobile number
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List existing medical conditions or illnesses (include asthma, diabetes, epilepsy, allergies etc.). Please outline treatment for each.
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Does the student require a medical plan through the school, eg ASTHMA Action Plan?
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Medication/s to be administered during the excursion. Include name of medication, instructions for administration, time of administration, and any possible reactions.
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Any other relevant information, e.g. travel sickness, etc.
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Dance Experience 
Do you participate in any dance classes? If so please identify where you train, which dance styles you participate in and how many days per week?
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Have you been a member of a dance ensemble before? (e.g., school dance ensemble or performance group). If so, which one/s?
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Why would you like to participate in the 2023 Riverina Wagga Wagga Primary Dance Ensemble?
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Privacy advice
The information provided on this form is being obtained for the purpose of ascertaining relevant medical information, requirements and other health care related needs about your child who is applying to participate in this activity.

The information will be used by officers of the NSW Department of Education and Training to assist planning, to support students, and to minimise risks when conducting these activities.

Other persons or agencies that may be provided with information include, but are not limited to, volunteers and members of external organisations who join with the school or are otherwise involved in the planning or delivery of the excursion, sporting or other school activity; and persons that may be called upon to provide health care treatment or other assistance during or as a consequence of such excursions or activities.

Provision of this information is not required by law. However a failure to provide the information may mean that your child can not participate in a particular excursion or school activity. In such circumstances the school will make available an alternative educational experience.

Provision of the information will significantly assist the school in planning a safer educational activity. This information will be stored securely. If you have any concerns about provision of this information, please contact the school principal to discuss further. You may correct any personal information at any time by contacting the event coordinator.
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