0439 424 2013 Harris st Yarraville Vic book a trial class!
YOUR FIRST LEAP STARTS HERE
Complete the details below and our team will review your request and confirm your trial by email.
01
Tell us a little about your dancer.
First name *
Last name *
Gender * Select genderMaleFemalePrefer Not to Specify
Date of birth *
02
Leave these fields blank if they don't apply.
Allergies
Medical conditions
Medications
Disabilities
Additional support or special needs
Photo consent *
May we use photos of your child on the Leaps N Beats website, flyers or social media?
Please selectYesNo
03
Home address *
Suburb *
State *
Postcode *
04
Your primary contact details.
Relationship * Select relationshipMotherFatherStep MotherStep FatherGrandparentRelationCaregiverGuardian
Mobile *
Email *
05
Optional.
First name
Last name
Relationship Select relationshipMotherFatherStep MotherStep FatherGrandparentRelationCaregiverGuardian
Mobile
Email
06
How did you hear about Leaps N Beats? Please selectBring-A-Friend-DayFlyerWord Of MouthWalk InSocial MediaInternet Search
07
Please review and accept each item before submitting.
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 endeavour 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 and 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 understand and accept that due to the nature of dance training some physical contact may be necessary by staff to demonstrate exercises or technique during class.
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 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 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.
We'll review your request and confirm your free trial by email.