KJ Dance Enrolment 2022
Please fill out the following details to secure your child's place in classes at KJ Dance.
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Parent's First & Last Name *
Address *
Email Address *
Contact Phone Number *
Student's First Name *
Student's Last Name *
Student's Date of Birth *
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Allergies *
Medications *
Where did you hear about KJ Dance? *
How do you prefer to pay your fees? *
How often would you like to receive your fees? *
Class Selection *
Required
PHOTOGRAPHY RELEASE - I understand that KJ Dance may take photos of my child at the studio, or at any other dance school events & video footage in class or at end of year Shows. I, as the parent or guardian will allow these photos or footage to be made public for advertising purposes. *
Required
RELEASE OF LIABILITY - I understand that KJ Dance accepts no responsibility for injury or loss caused during classes or whilst students are at or near the dance studio including common area (i.e. driveways) You are responsible for ensuring that your child is physically and medically fit for the class. *
Required
MEDICAL EMERGENCIES - In any event of an accident or emergency I hereby authorise my child to be transported to a hospital for medical treatment & will hold KJ Dance or representatives harmless in the execution of such. I also agree to provide all medical expenses which may be incurred as a result of any injury sustained while participating at KJ Dance. *
Required
Date Completed *
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Annual Licence/Admin Fees Paid ($55 per year / $65 per year 2 or more children) *
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