2020 VERCHOVYNA SCHOOL ENROLMENT FORM
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Email *
Dancer Details
Surname *
Given Name - Dancer 1 *
Date of Birth - Dancer 1 *
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DD
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Mobile Number - Dancer 1
Given Name - Dancer 2
Date of Birth - Dancer 2
MM
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DD
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YYYY
Mobile Number - Dancer 2
Given Name - Dancer 3
Date of Birth - Dancer 3
MM
/
DD
/
YYYY
Mobile Number - Dancer 3
Address *
Telephone *
Email #1 *
Main email used for Verchovyna correspondence
Email #2
Are you a 2020 CYM Member?
CYM Memberships will be checked and invoiced if selected YES. Discounts apply.
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Note – Completion of all fields is required including one suitable email address. Email is used regularly for Verchovyna communications. Please notify Verchovyna Administration of any changes to contact details throughout the year by emailing info@verchovyna.com.au
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