Enrolment Form
Butterfly Ballet School - Enrolment Form
STUDENT
Please provide the student details here.
First Name *
Your answer
Last Name *
Your answer
Date of Birth (DD/MM/YY) *
Your answer
Does the student have any medical conditions? * *
If you answered Yes to the above question please provide more details below.
Your answer
ENROLMENT
Please enrol the student in classes at the following location.
Location *
Which class is the student attending? *
Your answer
Contact Number *
Your answer
PARENT/GUARDIAN
Please provide the parent/guardian details here.
First Name *
Your answer
Last Name *
Your answer
Email *
Your answer
Relationship to student *
Your answer
Address *
Your answer
Additional comments *
Your answer
CONSENT
Please mark the tick box to confirm that you agree to our terms and conditions
(http://butterflyballetschool.ie/terms-and-conditions/)
I agree *
Required
Signed (Enter Full Name Below) *
Your answer
Date *
Your answer
Submit
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