Make a Dance in a Week Registration Form
Tracks School Holiday Program, 16-20 April 2018

Workshops are delivered in 2 sessions from
Mon 16 - Thu 19 April
10 - 1pm Years 4-6
2 - 5pm Years 7-12

Friday 20 April is a final day of rehearsal and performance
11.30 - 5.30pm all participants

Participant's name: *
Your answer
DOB: *
Your answer
School & year level: *
Your answer
Dance Experience: *
Your answer
Any current or pre-existing injuries: *
Please write n/a if not applicable
Your answer
Special medical, dietary or other needs: *
Please write n/a if not applicable
Your answer
Parent/Guardian's name: *
Your answer
Contact phone number: *
Your answer
Contact email address: *
Your answer
Emergency contact name and relationship to child: *
Write As Above if same as Parent/Guardian
Your answer
Emergency contact phone number/s: *
Write As Above if same as Parent/Guardian
Your answer
Terms and Conditions
• Workshops commence on Monday 16th April 2018 until Friday 20th April 2018, and are open to all students who are in years 4-12 at school.
• Public performance by participants will be held at Frog Hollow Park on Friday April 20th from 5pm as part of Tracks' Live Darwin project, Tracktivation.
• Please ensure workshop participants are wearing comfortable clothing suitable for dancing.
• Please ensure participants arrive at the studio on time.
• While participating in workshops, all instructors’ directions must be followed.
• Participants agree to abide by the Tracks Code of Conduct.
• Please ensure Tracks has been advised if participants have any special medical, dietary or other needs.
• At time of scheduling all workshop information is true and accurate.
• In reserving a place in the workshop and paying the fee, you are agreeing to accept all the above conditions. The person who makes the booking does so on behalf of all the individuals included, and all are bound by the booking conditions.

Fees can be paid via:
• Direct deposit to Tracks Inc BSB: 085 933, Acc No: 578522526 (please include your child/ren's name as a reference and allow 2 working days for payment to clear)
• Sports Voucher redemption, or
• Cash at the Tracks office. Please note we do not have EFTPOS or credit card facilities at the office.

Deadline for registration and payment of workshop fee: Wednesday 11th April 2018 - email receipt of payment to

By checking this box I agree to abide by the terms and conditions above *
Signed for and on behalf of You (Parent/Guardian of participant) *
If you are filling out the form digitally - please type the words “Signed by me” followed by your full name in the field below. For example: Signed by me, John Smith.
Your answer
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