Trial/Enrollment Form

Welcome to Leaps N Beats Dance! All trials/enrolments are pending until the office has reviewed your booking to ensure that it's appropriate, then will confirm via email. In order to do a free trial class the below information needs to be filled out. If you do not recieve

Child # 1

Gender*

MaleFemalePrefer Not to Specify

Birth Date

Additional Information

Consent to use child’s photo on website, flyers and social media?*

YesNo

Family Information

Parent/Guardian #1

Relationship to child

MotherFatherStep MotherStep FatherGrandparentRelationCaregiverGuardian

Parent/Guardian #2

Relationship to child

MotherFatherStep MotherStep FatherGrandparentRelationCaregiverGuardian

Referral Information

How did you hear about us?*

Bring-A-Friend-DayFlyerWord Of MouthWalk InSocial MediaInternet Search

More Information

What day care or Kindergarten does your child attend?

What Primary school does your child attend?

Required Policies and Agreements

All medical conditions must be honestly disclosed on enrolment/trial forms

I've read the above and agree.

I hereby consent to my child participating in dance with Leaps N Beats Dance. I understand that every endeavor will be made to contact me prior to any medical attention being given. Where it is not practical to contact me, I hereby authorise the First Aid Officer, or designated representative of Leaps N Beats Dance, to seek medical intervention (including treatment, emergency transport, hospitalisation, anaesthesia, & medication) in the event of any accident, mishap or illness during my child's participation in the program throughout the year. I understand that these services will be sought at my expense and as deemed necessary and/or appropriate by the staff and team of Leaps N Beats Dance.

I've read the above and agree.

I understand and accept that due to the nature of dance training that some physical contact may be necessary by staff to demonstrate exercises or technique during class.

I've read the above and agree.

It is understood that Leaps N Beats Dance will not be held responsible for any injuries that occur during class activities or for any loss of personal belongings or clothing.

I've read the above and agree.

I agree and understand that no refunds will be given once payment has been received for the term even if I choose to terminate classes.

I've read the above and agree.

I understand I will not be eligible for a make-up class if I do not contact Leaps N Beats Dance and notify them of my absence before the class begins.

I've read the above and agree.

I AGREE TO ALL OF THE ABOVE

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