2011 Registration form

REGISTRATION FORM 2011
Parent’s Name: __________________________________ Address: ______________________________
Email: __________________________________________ _____________________________
Mobile: ____________________________ Home Phone: ________________________
Emergency Contact Name (if different to above) ______________________ Ph: _________________
Interested in: ⃝ Summer School ⃝ Performance Team ⃝ Eisteddfods
Private lessons: ⃝ Solo ⃝ Duo ⃝ Trio
Any allergies: ___________________________________________________________________________
Student name DOB Age at 1/1/11 Size Classes attending





Enrolment fee is $20 Payment to accompany registration form.
Students cannot participate until enrolment is paid.