Registration Form

Pupil Registration Form

Please complete in block capitals

Students Name: ............................................................................................Date:..........................................................

Parent/Guardian Name: …...............................................................................................................................................

Address: .................................................................................................................................................................................

.....................................................................................................Post Code: .......................................................................

Contact / Emergency Number: ...............................................................................................................................................................

Email Address: ....................................................................................................................................................................

Date of Birth: …………………………………………………………………………………….............................................................................

Details of Medical History/Concerns (treated in absolute confidence):

 

I have read, understood and agree to the Term & Conditions of the Joanne Ward Dance Academy including –

PAYMENT

Payment to be made by BACS or Cash.

Payment must be made by the second week of term.  Accounts unpaid by the fourth week of term will incur a 5% surcharge

JWDA reserves the right to suspend classes until overdue payments are received.

Multiple Child Discount will apply to all families with a second or any subsequent child of a family attending classes. 10% will be discounted from the total bill due.

NOTICE PERIOD

If a student wishes to give up a class JWDA must receive written notice at least half a term prior to the end date.

RESPONSIBILITIES OF PARENTS/GUARDIANS

Photography and Videography of students taken by JWDA may be used for publicity or reference. If you do not wish your child's image to be used for these purposes you must inform JWDA in writing.

If your child needs any medication during classes, I am unable to adminster medication. All students should be able to self-administer or have a parent/guardian in another room responsible for their care. I can only assist and help but not administer. I hold no responisbility for emergency treatment

Signed by parent/guardian: ............................................................................Date:..................................................

Print Name: ........................................................................................................

Please return the completed form to a teacher or return via email. If you would like to pay online my bank details