Easter Workshop Registration Form 22/04/17
Once you have completed this registration form, please make payment within 7 days to secure your child' place and we will contact you to confirm a place in your chosen workshop. If no payment is received within 7 days of receiving the registration form we cannot guarantee your child's place in the class.
Please ensure you complete all sections as this helps us to secure a booking and makes things run smoothly on the day.
Kelly's Dance Academy
Are you a new or existing student?
I am a new student
I am an existing student
Which workshop are you enrolling for:
Karrinyup Tiny Tots (2-4yrs) 9:30am - 10:30am 22/04/2017
Karrinyup Children's Combo (4.5yrs - 7yrs) 10:45am - 12:45pm 22/04/2017
Child's Full Name:
Child's Date of Birth:
Experience of Dancing:
Taken a few classes
6 - 12 months
12 months plus
Any additional needs / allergies:
Parent name / Guardian Name:
I consent to my child being photographed or being part of a video that may be used for marketing / advertising purposes. Please note no child will be named, face photographs are kept to a minimum and all material is used for the dance school purposes only.
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