Enrolment Form
Please fill out this form when coming along to Elevate for a FREE TRIAL or enrolling in a class.
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Email *
Student FIRST & LAST Name: *
I am wanting to: *
ELEVATE Location I Wish To Attend: *
Date of Birth & Age: *
Year at school: *
School / Centre Attending: *
Home Address: *
Parent Name: *
Parent Phone Number: *
Emergency Contact: *
Where did you hear about ELEVATE? *
Class / Day / Time: (e.g: Pre Primary Ballet / Monday / 3:30pm) *
Does the student suffer from any medical conditions or illnesses? Illness may require a doctors clearance before participating *
I Agree to the Following. By ticking this box, I agree to all Terms and Conditions stated here and on the Elevate website.         *
Required
SIGNATURE - Name & Date: (By typing my First and Last name here along with a date, I agree that this acts as my electronic signature. By typing my name, I agree to all the Terms & Conditions stated here and on the Elevate website - www.elevateperformingarts.com). *
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