ADULT ENROLMENT FORM

TERM 2 - 2024

"*" indicates required fields

NAME*

First Last

Date of Birth*

MM slash DD slash YYYY

AGE*

PRONOUNS

PHOTO ( HEADSHOT)

Photo taken from your mobile device will suffice. Only for internal records.

Accepted file types: jpg, gif, png, jpegpdf, Max. file size: 5 MB.

SELECT YOUR CLASSES

ADULT CLASSES

CLASSICAL BALLET ADVANCED - MON - 5.45 – 6.45 Term Only

JAZZ ADVANCED - MON - 6.45 – 7.45 Term Only

JAZZ BEGINNER - MON - 5.45 – 6.45 Term or Casual

CLASSICAL BALLET BEGINNER - MON - 6.45 - 7.45 Term or Casual

TECH & DYNAMICS ADVANCED *By audition only - SAT - 9.00 – 10.00 Term Only

ACTING - SAT – 10.00 – 11.00 Term Only

SONG & DANCE - SAT - 11.15 – 12.15 Term Only

CONTEMPORARY ADVANCED - SAT - 12.15 – 1.15 Term Only

JAZZ ADVANCED - SAT - 1.45 – 2.45 Term Only

CLASSICAL BALLET BEGINNER - SAT – 1.45 – 2.45 Term Only

JAZZ BEGINNER - SAT – 3.00 – 4.00 Term Only

CLASSICAL BALLET ADVANCED - SAT - 3.00 - 4.00 Term Only

HIP HOP (level to be determined by DW) - SAT - 4.00 – 5.00 Term Only

TAP (level to be determined by DW) - SAT - 5.00 – 6.00 Term Only

Total inc GST

PRIMARY EMAIL*

Please type your email twice (make sure it’s correct)

Primary email Confirm Primary email

Please note all correspondence/memos are distributed by email. DW does not issue invoices. EFT is not available.

BILLING ADDRESS*
No PO box address will be accepted

Street Address CIty State Postal Code

MOBILE PHONE*

Other than the person already listed as the billing contact

EMERGENCY CONTACT NAME*
First Last

RELATIONSHIP TO STUDENT*

EMERGENCY CONTACT NUMBER*

OTHER CONTACT NUMBER

EMERGENCY CONTACT EMAIL*
Enter Email Confirm Email

If you answer YES to any of the questions below, please provide more details in the space provided below.

Have you ever suffered from any serious illness or injury?*

YES

NO