New Student Enrolment Form

Please complete and submit this form so we can enrol you in our classes and generate your Family Account.

Enrolment Form

* Indicates required field

How did you hear about Bass Coast Ballet School? *

Name of person who referred you (so we can thank them) *

Where would you like to attend classes? *

Is the student under 18 years old? *

Mother or Guardian's First Name *

Mother or Guardian's Surname *

Mother or Guardian's Mobile Number *

Contact Email Address *

Father or Guardian's First Name *

Father or Guardian's Surname *

Father or Guardian's Mobile Number *

Is there a custody arrangement we should know about? *

Home Address - not PO Box *

Suburb *

Postal address - if different from street address *

Emergency Contact - other than parents *

Relationship to student *

Emergency Contact's phone number *

Student is: *

Female Male

Student's First Name *

Student's Surname *

Student's Contact Number - if Adult Student *

Date of Birth *

Day / Month / Year

Name of Kindergarten or school attending *

Year level at school *

Classes of interest *

Dance with Me Creative Dance Play Ballet Adult Ballet Contemporary * see requirements under Class Info tab Jazz Tap Adult Tap Hip Hop Adult Jazz

Does the student have any physical or behavioural issues that we should be aware of? Please describe: *

Does the student have any allergies? *

Any previous dance experience? If yes, please provide details. *

Submit