The Dance Gallery - Registration Form

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The Dance Registration Form

* Indicates Compulsary Field

Surname:*		Given Names:*
Address:*		Postcode:
DOB:*		Home Phone:*
Mobile 1		(Name)
Mobile 2		(Name)

Parents Names:*
E-Mail Address:*

Class or Classes Enrolled in.
Location(s)*
Belmont	Broadmeadow	Lambton	Hamilton	Maryland

Classes(s)*

Tiny Tot Tap	Pre-Junior Tap	Junior Tap	Intermediate Tap	Pre-Senior Jazz	Senior Tap 1
Tiny Tot Jazz	Pre-Junior Jazz	Junior Jazz	Intermediate Jazz		Senior Tap 2
Tiny Tot CheerDance	Pre-Junior Classical	Junior Classical	Intermediate Classical		Senior Jazz 1
		Junior Cheerdance	Intermediate RAD		Senior Jazz 2
		Boys Junior hipHop	Intermediate / Pre-Senior Modern		Senior Classical
			Boys Intermediate HipHop		Senior Classical Pointe
					Senior Modern


Would you like our newsletter sent to your E-mail address:*	Yes No


We will be paying by:*	Weekly Termly
Please note that this option can change from term to term.


How did your hear about The Dance Gallery?
Yellow pages	Website	Brochure	Radio	Friend	Other

Studio Video, Website & Photography Permission Form

Upon occasion The Dance Gallery may organise an individual or group to make official recordings of our ballerinas at events such as (but not limited to) our annual concert, costume day, public performances, presentation day, regular classes.
Video recordings and photographs are available to parents and are distributed through the studio and may be displayed on our website.
I give permission for my child to be videod & photographed by studio-authorised personnel.

Please tick as authorisation:*

Relationship to Child:*

Please Click Here to Read Studio Policies

I have read and agree to abide by the studio policies *

Please type the following code for authentication:*

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