ENROLMENT Form Student Name * First Name Last Name Gender * Female Male D.O.B * Age School Parent/Guardian Name * First Name Last Name Relationship To Student * Email Address * Address * Mobile * (###) ### #### Emergency Contact Name Emergency Contact Number What dance class would you like to enrol in? Does the student have any ailments, restrictions? Has the student had any previous dance training? If yes, name of current/previous dance school? How did you hear about us? Permission and Publications: * At Passion & Purpose Academy, we use our website and social media pages to promote our services further to the general public. We also video class routines and send to students/parents so the student can practice further at home. Please let us know your preference with regards to your child's photos/videos. Option One: I DO give permission for my child’s pictures(s)/ video(s) to be used by Passion & Purpose Academy for their: Website, Facebook/Instragram pages, local newspaper/marketing material. Option Two: I DO NOT give permission for my child’s pictures(s)/ video(s) to be used by Passion & Purpose Academy for any of the above. Option One Option Two Indemnity * I acknowledge and agree that Passion & Purpose Academy, its employees and contractors shall not be responsible for the loss or damage to a students or visitors personal property. Students and visitors bring all property to the Academy at their own risk. I give my consent for my child to participate in dance classes and agree to delegate my authority to the staff and instructors involved. All dance, exercises and participation is done at the risk of the child. Passion & Purpose Academy is not responsible for any personal injury arising. To ensure the safety, wellbeing and successful conduct of the students as a group, or individual in the above mentioned activities, staff may seek to discipline students (which may include removal from a class) should inappropriate conduct occur. I also authorise the instructors to obtain medical assistance if required and I agree to pay all medical expenses incurred on behalf of my child. I Agree I Disagree Fees * Parents/Guardians are fully responsible for the tuition payments in accordance with the Passion & Purpose Academy dance fee policies. Tuition is non-refundable and is due in full by Week 1 of each term. No refunds are offered after commencement, with the only exception due to a prolonged illness, injury or a family move. Free class trials are offered for all new students and payment will only commence the week after trials. Additional charges will apply for costumes at both mid-year and end of year concerts. Please see payment information page for bank details and instructions on how to pay tuition. I Agree I Disagree Declaration (Parent/Guardian Name) * I hereby declare that I agree to the above information, and that the information I have provided is an accurate record of my child and their health. I understand that it is my responsibility to inform Passion & Purpose Academy of any changes to these details. First Name Last Name Date * Thank you for enrolling with Passion & Purpose Academy. You will hear from us shortly!
