REGISTRATION 2012

 

  

 

HOW DO I REGISTER?

 

Step 1:  Complete the form below so that we may prepare a registration file from the information you submit.

Step 2:  Visit us at reception to sign your payment schedule/debit form & to pay your registration fee.

 

 

____________________________________________________________________________ 

 

For insurance purposes & to be eligible for lessons, all students aged 3-15 years including returning students must complete the form below before entering any lesson at Razzle Dazzle Dance Studio.  Up to 2 siblings may complete the same form (for 3 or more, please submit a separate form).

 

Please take a look at our 2012 Timetable and our 2012 Terms & Conditions before registering.

 

Unsure what age group your child should be in?  Take a look at our Class Guide.

 

NB:  16 yrs+ Casual students do NOT need to complete this form.

 

*Mandatory Field

Please complete the following details
*Students Name
*Age as of Jan 30, 2012
 
*D.O.B. (dd/mm/yy)
 
*School grade/year
Student No. 2 Name
 
Age as of Jan 30, 2012
D.O.B. (dd/mm/yy)
School grade/year
 
*Address
*Suburb
*Postcode
*Parents Names
*Home Phone
Work Phone
*Mobile
Students Mobile
*Emergency Contact Name
*Emergency Contact Number
*Parents Email
Student Email
Please list any medical conditions/injuries that teachers
should be aware of:
*How did you hear about us?
Please select your classes for 2012 (Student No. 1)
*Class 1
Class 2
Class 3
Class 4
Class 5
Class 6
Class 7
Class 8
Class 9
Class 10
Please select your classes for 2012 (Student No. 2)
Class 1
Class 2
Class 3
Class 4
Class 5
Class 6
Class 7
Class 8
Class 9
Class 10
Registration & Fees 2012
*Registration
*Fees/Packages
 
*For multiple classes including Dance & Dazzle, please add $2 for 3-4 yrs & $5 for 5-6 yrs
Please enter the following Information so that a direct debit form can be prepared in advanced. Please note that by filling in these information fields you are not authorising a debit - a signed debit form is the only way we are authorised to take money.
*Surname
*Given Name
*Mobile
*Would you like an sms reminder?
*Debit Form
*Frequency
*Please suggest a suitable date in January or February we may start these debits for you
NB: Term payments are automatically debited first day of each term 
 Direct Debit Details
*Name of Financial Institution
*Branch
*BSB
*Account Number
*Account Holder Name
OR
Credit Card Type
Expiry Date (mm/yy)
Name of Cardholder
 
IF YOU HAVE ENTERED YOUR CREDIT CARD DETAILS FOR DEBIT, PLEASE NOW TYPE "N/A" INTO THE FIVE FIELDS ABOVE FOR BANK ACCOUNT DETAILS SO THAT THE FORM WILL ALLOW YOU TO SUBMIT.
Comments
 
 
 
 I have read a copy of & agree to the 2012 Terms & Conditions