2019 Enrolment Form

Download a copy of the 2019 Enrolment form OR fill in the following form and just hit submit!

If you are interested in one of our classes which is currently full, please email us at vmsdancestudio@gmail.com to join the waiting list.

The information requested on the form is essential for assisting us to plan for the support of your/your child’s health needs and communication methods. It will be used by Vital Movement Studios only. If you do not provide all or any of this information, the studio’s capacity to support your/your child’s health needs could be impaired. This information will be stored securely. You may correct any personal information provided at any time by filling in another enrolment form that can be printed off our website. It is your responsibility to ensure a new form is filled out should your contact or medical information change.

PLEASE FILL OUT EVERY SECTION OF THIS FORM

Student's Name *
Student's Name
Submit numbers only
If applicable
Student's Address *
Student's Address
Not required for students aged 18ys +
Parent/Carer 1 Name
Parent/Carer 1 Name
Parent/Carer 1 Address
Parent/Carer 1 Address
Not required for students aged 18ys +
Parent/Carer 2 Name
Parent/Carer 2 Name
Parent/Carer 2 Address
Parent/Carer 2 Address
Emergency Contact 1 *
Emergency Contact 1
If parent/carer is unavailable
Emergency Contact 2
Emergency Contact 2
Jazz Classes
Please select the Jazz classes you/your child would like to enrol in
Tap Classes
Please select the Tap classes you/your child would like to enrol in
Tiny Tots
Cardio Barre Class
Please select the Cardio Barre classes you/your child would like to enrol in
Ballet Classes
Please select the Ballet classes you/your child would like to enrol in
Hip Hop Classes
Please select the Hip Hop classes you/your child would like to enrol in
Contemporary Classes
Please select the Contemporary classes you/your child would like to enrol in
Acrobatic Classes
Please select the Acrobatic classes you/your child would like to enrol in
Strength and Stretch
Please select the Strength and Stretch classes you/your child would like to enrol in
Medical
Please select if you/your child suffer from any of the following
If you selected any of the above please give details I.e. severity of condition, frequency of medication
Consent *
I understand that some physical contact may be necessary by a staff member to demonstrate exercises or technique during classes. I accept that Vital Movement Studios trained staff will administer first aid and/or call emergency services in the case of any accident or injury during class, and that I will be sent any subsequent medical bills. While Vital Movement Studios takes all reasonable care in the conduct of its classes, I acknowledge that there is possible risk of injury involved with participation in dance. In allowing myself/my child(ren) to participate in Vital Movement Studios activities, I hereby assume all the risks associated with the performing arts. I understand the importance of myself and my child(ren) following the instructions and rules set by their teacher/s, and I agree to release Vital Movement Studios and its staff of any and all liability which may arise as a result of my/my child(ren)’s participation in activities at Vital Movement Studios.
How did you find us? *
Sports Voucher *
I have a valid 2019 Sports Voucher to claim on VMS dance fees
Payment Options *
Payment plans available to any student who has completed one full term at VMS
Photography and Videography Release *
I, the undersigned, give permission for Vital Movement Studios to use video footage and/or photographs of myself/child(ren). This usage may include (but is not exclusive to) displaying publicly, distributing, or publishing, photographs, and/or video of my child for use in materials that include, but may not be limited to: - printed materials (eg - brochures and newsletters) - online and offline advertising and promotion - videos and digital images such for use on Social Media By checking this box, I acknowledge that I am giving unrestricted permission for my/my child’s image to be used in print, video, and digital media. I agree that these images may be used by Vital Movement Studios for a variety of purposes and that these images may be used without further notification. I do understand that any identifying information including surname and location will not be used in conjunction with any video or digital images.
Declaration *
I admit to the information given as being true and correct and take full responsibility for any incident arising where information has been withheld. I understand that I am required to pay my account for all tuition undertaken at Vital Movement Studios, and have read & agree with the fee policy as stated in the 2019 VMS Handbook.
Electronic Signature *
Electronic Signature
I consent to electronic enrollment. By placing my name in the box below, I acknowledge that I am signing this agreement and warrant that I am authorised to sign.