2021 YVB Summer Program, Student Enrolment Form (18+ years)
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Email address
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Your email
Section 1 - Student Information
Student Name
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Your answer
Student Date of Birth
Your answer
Contact Number/s
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Your answer
Emergency Contacts
1. Name, Relationship, Contact Number
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Your answer
2. Name, Relationship, Contact Number
Your answer
Dance Background / Information
Previous Dance Experience
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Your answer
Medical Information
Please advise any allergies or medical information of which we should be aware
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Your answer
Please advise any injuries, minor or major, that may affect your ability to participate in classwork
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Your answer
Student Safety Policy & Injury Liability Waiver
Yarra Valley Ballet subscribes to the Ausdance Safe Dance Practice Guide, available at:
http://ausdance.org.au/articles/details/safe-dance-practice
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Student safety is of utmost importance at Yarra Valley Ballet. Alongside physical and environmental safety, we encourage and promote mental and emotional well being which includes a balanced approach to training, healthy eating habits, and fatigue and injury management.
Whilst every effort is made to manage and mitigate risk, accidents can happen. In the event of an injury, we recommend students seek medical advice from a qualified professional. YVB staff will work alongside the student and family to facilitate rehabilitation and re-integration to classes.
INJURY LIABILITY WAIVER
We agree that we will not hold Yarra Valley Ballet Pty Ltd or any of its Directors liable for injuries sustained in the normal course of dance class activity.
Please indicate your agreement to the above Injury Liability Waiver
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Yes, I understood and agree to the Injury Liability Waiver
No, please contact me to discuss
Required
Visual Media Policy
From time to time YVB teachers may take photos and/or video footage of students during class time. This media is used for educational purposes only and may be shared with enrolled families of the class and/or YVB staff.
Photographs and/or video footage may also be taken during theatre rehearsals and performances and may be shared with the YVB community through email and/or our closed Facebook page (ie not the public page).
If we wish to use any images or footage publicly, we will seek your express written consent where the image or footage visually identifies you. Public use may include our website, public Facebook page, or advertising materials.
Please indicate your agreement to the above policy
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Yes, I understand and agree to the above Visual Media Policy
No, please contact me to discuss
Required
Fee Policy
All Summer Program Fees must be paid prior to class commencement.
Our preferred payment methods are cash or direct deposit.
Yarra Valley Ballet Pty Ltd | 013 278 | 224433446
We offer a 100% refund for:
• student who cannot continue for medical reasons supported by a doctor's certificate
• for all future scheduled classes only.
We do not offer refunds for classes that have already been taken, or retrospective classes missed due to illness/injury/choice/circumstance.
Please indicate your agreement to the above policy
*
Yes, I understand and agree to the above Fee Policy
No, please contact me to discuss
How did you hear about Yarra Valley Ballet?
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Facebook
Other
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Is there anything else you would like to advise or discuss?
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