Toorak School of Dancing

Established 1980

ENROLMENT FORM

Please complete and submit our on-line enrolment form or, if you prefer, you can download this pdf and submit by mail.

In submitting this enrolment form you acknowledge that you are the child's parent or legal guardian and that:

"In case of accident or illness - when I cannot be contacted, the staff of the Toorak School of Dancing have my permission to seek medical assistance for my child and I will be responsible for any costs involved."

Student's Name *
Street Address *
Suburb *
Postcode *
Date of Birth *
Phone
Email *
Details of Parent or Legal Guardian - details of at least one required
Mother's Name
Mother's Mobile
Father's Name
Father's Mobile
Emergency Contact Number *
Commencement Date
Classes - select the classes for enrolment:
	Ballet		Contemporary
	Jazz		Hip hop
	Tap		Pointe
	Examination		Conditioning
Please advise any medical conditions we should be aware of, if none, insert "Not Applicable" *

Photo Consent		(optional)
I hereby grant permission for Toorak School of Dancing to use any photograph of the student named above for the purpose of promoting the school via printed or electronic means (website).
Photo Consent - Facebook		(optional)
I hereby grant permission for Toorak School of Dancing to use any photograph of the student named above for the purpose of promoting the school via Facebook.
		* Mandatory values

Camberwell VIC 3124 ~ For further details, contact Debra 0439 898 574, Sylvia 03 9555 0035 or email