Leave this field blank Student Name Student Last Name Student D.O.B Students Age Address Student Medical Conditions (if any) Please write Nil in none PARENT /CARER Name 1 PARENT /CARER Last Name 2 PARENT / CARER 1 Relationship to Student PARENT / CARER 2 Contact Number PARENT / CARER Email (Primary Contact Point) Optional additional Email address for correspondence (optional) Emergency Contact Name Relationship to Student Emergency Contact Number CONDITIONS OF ENROLMENT I understand that while the upmost of care is taken, participation in dance classes carries a risk of physical injury. Each Student participates at their own risk and teachers/staff of Mareeba Academy of Dance are not liable for any injuries sustained during classes. I appreciate that dance is a tactile art form and student/teachers will have physical contact in class I give permission to use photographs/videos of the above student for publicity and memorabilia purposes. (OR if permission is not given I will personally email Regan ([email protected]) with student details for follow-up and flagging. Note: it is the student/parent responsibility to remove themselves from announced group photos where possible.) I will ensure my child and I both understand Mareeba Academy of Dance code of conduct and policies and will help to enfore them with positivity. Please indicate that you have read and agree to the Terms and Conditions of Mareeba Academy of Dance Policies Send
