Hobart Enrolment | Dance Culture Co

Use this form for Hobart Enrolments Only

Students First name

Students Last name

Birthday

Day

Month

Year

Address

Email (All newsletters sent via email)

Phone

Emergency Contact Name

Emergency Contact Phone Number

Emergency Contact Relationship to Student

Does the student have any Medical Conditions we need to know about?

Is anyone else permitted to collect the student from class? If so, please list all names of authorised people below.

Do you give permission to be featured on Dance Culture Co. socials? (Instagram, Facebook, Website, etc)

Yes, I give permission for mine/my childs images to be used on DCC socials.

No, I do not give permission for images of me/my child on DCC socials.

Whilst Dance Culture Co. takes dutiful care in providing safe dance practices, it holds no responsibility for injury sustained or loss of belongings whilst on our premises.

In the case of injury, emergency contact will be notified.

By signing, you also agree to pay all tuition and costume fees in full by due dates given on invoices. No refunds will be given for payments made.

Ceasing classes at Dance Culture Co. must give 14 days notice.

By ticking this box I agree to the above terms and conditions.

Name

Signature of Student or Authorised Guardian if under 18 years old

Signature field is empty.

Date