Registration Form

Personal Details

Given Names *

Family Name *

Date of Birth *

Gender *

MaleFemaleOther

Student Address

Street address

City

State

Postcode

Student Medical Conditions *

Tick if you are a New Student

Registration fee does not need to be paid if you are a new student, only after your free trial.

Contact Information/ Person Responsible for Fee's

Given Names *

Family Name *

Email Address *

Email Address # 2 *

Mobile

Mobile Number # 2

Address

Street address

City

State

Postcode

Emergency Contact

Name *

Relationship

Mobile

STUDENT PUBLICITY REALEASE:

Enter your name *

I here-by give permission to DanceXpress Academy to take photographs, film, or videos of my child for the exclusive use of DanceXpress Academy. I consent to the use of such materials and/or the use of my child's name for DanceXpress Academy promotional purposes such as marketing brochures, posters, fliers, video, facebook, instagram and website of DanceXpress Academy. *

Parent/Guardian Signature

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Parent/Guardian Declaration and Consent

Enter your name *

As a parent/ guardian I understand that all dance and fitness classes can involve risk of personal injury. While DanceXpress Academy takes all responsible care in the conduct of its classes, it accepts NO responsibility for injury or loss called during classes, at any DanceXpress event or whilst students are near the premises of the dance school. You and the student are responsible for ensuring that they are physically and mentally fit for class and during the class students must take care of their own personal safety at all times. As a parent/ guardian of the above student I understand DanceXpress Academy promotes safe dance practice in a fun, supportive and happy environment. DanceXpress Academy encourages fitness whilst supporting students in their passion for dance and performing arts. I agree to abide by all DanceXpress Academy Policies, Terms and conditions as set out in the 2024 Information Booklet. By signing this Registration form, I affirm that I have read, agreed to and understood the 2024 Terms and Conditions. I agree to pay the $30 Registration fee for my child below direct deposit. *

A Registration Fee of $30 must be paid per child to secure your place.Account: Alisha Lovatt T/A Dancexpress Academy BSB: 013-479 ACCOUNT: 2124-55701 *

Signature *

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Classes commence back on Monday 5th of February