ENROLMENT FORM | starz-dance-wa

STARZ ENROLMENT FORM

Student Full Name (first, middle, surname)

Student Date of Birth (DD/MM/YYYY)

Please share some details of your child's diagnosis (including any sensory/emotional support or additional considerations our team should know about)

Please share details on your child's favourite songs/music/artists (we will try to add these to our class playlist!)

What do you hope your child will achieve from their experience with Starz Dance? (eg. socialization, gross motor skills, fitness etc)

Parent/Guardian contact name & relationship to student

Parent/Guardian Phone number & mailing address

Will this student be accompanied by a support worker/carer? If so, please advise their name & the level of assistance they will be giving the student.

I have read & agree to the terms and conditions of enrolmentView terms of enrolment

Thank you for registering your interest in the Starz Dance Classes. A member of our team will get back to you within 3x working days.