Student Registration Form
Please fill up all the required fields!
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Email *
Please select the program you want to register: *
Required
Please select which week you book: *
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Required
Student - First Name *
Student - Last Name *
Student - Gender *
Female
Male
Student - Date of Birth *
MM
/
DD
/
YYYY
Parent - First Name (for adults put your name) *
Parent - Last Name (for adults put your name) *
Student - Allergies *
YES
No
Parent Cell Number (Adult Student cell) *
Address *
House Number/ Flat Number
Address *
Street
Address *
City
Address *
Posta Code
Emergency Contact Name *
Emergency Contact Cell Phone *
Ballet Schools attended before *
A copy of your responses will be emailed to the address you provided.
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