REGISTRATION FORM 2010

So, You want to be part of the DW DANCE family?? No problem, Simply print and fill out the below form PHONE Miss Dodie today!

Registration fee of $30.00 is required to secure your position and to pay for your insurance.

Please highlight and print out the below form

REGISTRATION FORM 2012

Students First Name:

Students Surname:

Students Date of Birth:

Parent’s First Names:

Parent’s Surname:

Full Home Address:
(please include your postcode)

Email address:
Enrolment Date:

Home Phone Number:

Parents Mobile Numbers: 1:
2:

Does the child have any allergies ? If so, What?

How did you hear about DW Dance?

Emergency Contact phone number:
(Please make this someone other than a parent. The parents are always the first point of call, but in an emergency, IF the parents cannot be reached I need another person who can be contacted)

Please tick the classes you wish to enrol for. Your placement in the class is only guaranteed after registration is paid.
TINY TOTS 3-4 yrs	JUNIORS 5 -7yrs	Intermediates 8 - 12 yrs	SENIORS 13 +
Tap Ballet Jazz Competition	Tap Ballet Jazz Hip Hop Competitions Modern / Contemporary	Tap Ballet Jazz Hip Hop Competitions Modern / Contemporary	Tap Ballet Jazz Hip Hop Competitions Modern / Contemporary

ADULTS	ACROBATICS (All ages)	GLEE Class all ages Song & Dance	MUSCIAL THEATER - all ages CHEERLEADING - All ages CHEERLEADING TRICKS & TUMBLES - All ages

	HIP HOP for BEGINNERS 13 yrs _+
Your Registration Fee of $30.00 has been paid – Signed by

HOW TO PAY AT DW DANCE ACADEMY

Cash :

If you wish to pay cash, please put the correct money in an envelope, with your child’s name and pay the ladies at our front desk.

Direct Deposit:

If you wish to direct debit, please do so BEFORE the weekly lessons and place a printed receipt of payment to the ladies at our front desk.

You will then get a receipt with your payments on it monthly with your newsletter. Please get the account details from Miss Dodie.

Account Details:

Account Name: Dodie Wilson

Account Number: xxxxxxxxxxx

BSB: xxxxxxxx

St George Bank.