2019 GCC Dance Academy
GCC Dance Academy Enrolment Form
Student first name *
Your answer
Student last name *
Your answer
Student Gender *
Required
Student Date of Birth *
MM
/
DD
/
YYYY
Year Level in 2019 *
Classes I wish to enrol my child in *
Required
Medical or Special Needs ie. allergies, medical details etc *
Your answer
Additional Comments - ie. prior experience
Your answer
Primary Parent/Carer Contact Details - Name *
Your answer
Relationship to Student *
Your answer
Street Address *
Your answer
Email Address *
Your answer
Home Phone Numer *
Your answer
Mobile Phone Number *
Your answer
Secondary Contact details - Name *
Your answer
Relationship to Student *
Your answer
Secondary Contact Email *
Your answer
Secondary Contact Phone Number *
Your answer
Photo Permission - GCC Dance Academy includes photos/videos in newsletters, on the website and social media etc. As a parent or guardian of this student, I hereby consent to the use of photographs/video taken during the classes *
Required
I have read and agree with the GCC Dance Academy Terms & Conditions of Enrolment *
Required
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