Re-enrolment Form 2017 Re-enrolment Form 2018 This form is for existing Vibe Dance Studio clients only. EARLY BIRD re-enrolment fee is $20.00 per family. Re-enrolment online form must be received by 22 December 2017 to be eligible for the early bird fee. STANDARD re-enrolment fee is $30.00 per family. Parent/Guardian/Carer's Details * Name First Last * Address Street Address Address Line 2 City State / Region / Province ZIP / Postal Code Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Cote d'Ivoire Croatia (Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and Mc Donald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Lao, People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia, The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province of China Tajikistan Tanzania, United Republic of Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe Country * Phone * Email Student's Details Child/ren's name and date of birth * Please select the class/es you are enrolling into for 2018. Tiny Tots (Born in 2014 or later) Beginner Dance (Born 2013) Junior Dance (combo - ballet, tap, jazz) Ballet Jazz Tap Contemporary Hip Hop Musical Theatre Acro/Cheer Boys Only Please only select the options you are actually enrolling into. We develop our timetable from these preferences. Is your child interested in? Assessments Eisteddfods - Groups Eisteddfods - Solos Community Performances (ie. Fetes etc) Medical Details Allergies Medical Conditions (including past injuries) Terms and Conditions * Do you give permission for your child/ren to be used in any of Vibe Dance Studio’s marketing materials? Yes No * * I have read and understood Vibe Dance Studio’s Code of Conduct. Yes No * Disclaimer: I hereby give permission for my child/ myself (if over 18yrs old) to participate in classes conducted at Vibe Dance Studio. I fully understand that participating in these dance classes is at my child’s/my own risk. Whilst all necessary precautions will be taken to ensure the safety of every student, no responsibility will be taken by the studio or anyone involved with the studio. In the event of a medical emergency (when the emergency contact cannot be contacted) I give permission for staff of the dance studio to seek medical advice for my child/ myself and/or arrange for emergency transportation for my child/ myself to the closest medical facility. I accept the terms and conditions of this enrolment form. I DO NOT accept the terms and conditions of this enrolment form. * Field Label
