Class Registration Form

Student Name

Parent Name (if student under 18yrs old)

Date of Birth

Postal Address

If Yes, please specify. Includes: Injuries, Physical Disabilities, Allergies or Illness. E.g. Asthma, Epilepsy, Diabetes, Sight, Hearing, Food Allergies etc.

Phone

Email

Class Options

Heels Choreography (16yrs & up)‎ Afro / Dancehall Fusion (16yrs & up)‎

Do you have any Medical Conditions

Emergency Contact Person

Emergency Contact Phone Number

How did you find out about these classes?

If other, please describe.

TERMS OF SERVICE

All Classes must be paid in full by the first week of term.

There is no refund or exchange on class fees. No refunds are given for missed classes, or if you cannot complete the term.

Registration forms must be fully completed and signed before commencing the first class.

The timetable may be subject to change. If this occurs, Anne will do her best to inform all students of these changes as soon as possible. If for any reason Anne Tolentino needs to cancel a class, Anne will arrange a make-up class and try her best to accommodate for all students.

DECLARATION

Reasonable care concerning the safety and welfare of students is taken in all workshops and classes conducted. Anne Tolentino shall NOT be held liable or responsible for any lost property, any sickness or injury incurred before, during or after class or traveling to and from class.

Any images or video taken may be used for Anne Tolentino's promotional use. If you object to having your image or video used in marketing materials, please let Anne know prior to class commencement. 
 
If you are under the age of 18 years, a parent/guardian will be required to sign and date the declaration below on your behalf.

Accept "Terms of Service"

I have read and accepted the "Terms of Service".

Signature of Student or Parent / Guardian Signature (If student is under 18 years)

Clear

Date