Learn Circus This School Holiday
Tuesday 16th - Wednesday 24 April
At the Freo Big Top, 90 Adelaide St, Fremantle
ACT crazy BELONG to community and COMMIT to Fun
Participant Information
Participant's Name: *
First Name & Surname
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Participants Age: *
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Emergency Contact Name: *
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Medical Issues: *
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This April choose between a focused 3 session (9hrs) intensive program designed to give you a solid grounding in a circus specialty. Or Come and enjoy a fun exploration of all things circus at one or all of our Big Top Circus Skills sessions.
LEARN ACROBATICS: $110 (3 session program)
LEARN AERIALS: $110 (3 session program)
LEARN STILTS & UNICYCLE: $110 (3 session program)
BIG TOP CIRCUS SKILLS (3hrs): $45.00
BIG TOP CIRCUS SKILLS (2hrs): $35 OR $65
PAYMENTS
NB there are limited spaces in the Intensive programs. Upon completion of this form please transfer payment to confirm your spot.

You can make payment by DIRECT TRANSFER to the below account
Or call the office to pay via CREDIT CARD

NEED TO CANCEL? We know surprising life things turn up. We will happily re-imburse you the fee, however we will need to deduct an admin fee (50% of the original fee) for any cancelation.

CIRCUSWA BANK DETAILS
The WA Circus School Incorporated
BSB: 082 356
ACC: 94 599 1368

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Billing Information
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*Enter parent/guardian name if participant is under 18 years of age.
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Suburb you live: *
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Indemnity Agreement
Indemnity Agreement 2019 *
I indemnify and release the WA Circus School and their trainers against all costs incurred, expenses and all liabilities whatsoever arising as a result of the Participant’s actions or trainer instructions during all activities undertaken within the WA Circus School training space and any performances in collaboration with CircusWA that may arise. I understand that the Participant must follow safety instructions and guidelines for using equipment as CircusWA does not accept liability for personal injury. I understand that CircusWA strives to ensure that a high level of safety is maintained at all times. I understand that the Participant voluntarily participates in any activities undertaken with CircusWA. I authorise CircusWA to seek appropriate medical attention in the event that the Participant is injured. I agree to indemnify and release CircusWA and trainers from today until 31st December 2019.
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Photography Agreement 2019 *
I understand that the classes may be photographed by the WA Circus School for archival and marketing purposes. I agree to photos of myself/my child being used for the above stated purposes.
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Emergency Agreement 2019 *
In the case of an emergency, do you consent to an ambulance being called for yourself/your child
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Date: *
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And one last question... How did you hear about us? *
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