thepalacedanceprogram.co.nz

About You

Your first, middle and last name (required)

Your date of birth dd/mm/yyyy (required)

Your gender (required)
---MaleFemaleNon binary

Ethnicity (required)

Your Email (required)

Mobile number (required)

Home Phone number

Home Address (required)

What school are you attending

Year level

OR

If you are not currently enrolled at a secondary school, what is your employment status?
---UnemployedPart-timeFull-timeTertiary Study

Do you have any medical issues or injuries we should be aware of?

Which Location are you able to attend:
---ManurewaPapakuraOtaraMangereOtahuhuPapatoetoe

Do you require transport?
---YesNo

Parent/Guardian Contact Details

Primary Contact:
First and Last name (required)

Mobile number (required)

Email (required)

Relationship to student (required)

Anything else?

Liability Waiver
The Palace Dance Studio is not liable for personal injury or any loss or damage of personal property, whilst on the premises.
The Palace Dance Studio will aim to provide a safe learning environment to reduce risk of injury. It should be recognised by all students, parents/guardians that dance by its very nature carries a risk of injury or accident.

The Palace Dance Studio provides qualified and/or experienced dance teachers, who actively promote safe dance practice. This being the case, it should be realised that injuries do occur from time to time and students must accept this element of risk.
It is the student's parents/guardians responsibility to notify their teacher in the event of injury/medical condition prior to class.
Prior to the commencement of the class, it is the student's or parents/guardians responsibility to inform their teacher of any injury which is being treated or may be of concern.

A First Aid Kit is available to any student through their choreographer or centre administration. We do not provide anyone with Panadol or equivalent or administer students medication.

The Palace Dance Studio participants are under supervision whilst in class time, as well as travel to and from the location. We will endeavour to provide a safe environment, however it is required by you, the participant, that you will follow and adhere to any guidelines or directions by your choreographer, teacher, transport driver or any other personnel who assist with the running of this program.

Regular weekly class attendance is vital for students to develop and keep up with the syllabus for the year. Students must be punctual to ensure they receive a complete warm up.

The Palace Dance Studio also maintains the right to dismiss any student who breaches any of the stated Terms and Conditions, damages property or causes disruptions to any classes of a severe nature. The decision is at the discretion of the dance Directors.

This enrolment form collects personal information about you. Under the Privacy Act 1993, you are entitled to have access to, and request correction, this information which is held at The Palace Dance Studio's premises at 605c Great South Road, Manukau, Auckland, New Zealand

(required) by ticking this box I agree to all the terms above and confirm at the start of the workshop I / my child, will be 16 years of age or over