ENROLMENT FORM BABYBALLET HOPPERS CROSSING CLASSESPLEASE SELECT YOUR CLASS*Tots (6-18m) Wednesday 9:00amTinies (18m-3yrs) Wednesday 9:30amMovers (3 & 4yrs) Wednesday 10:00amTappers (3yrs +) Wednesday 10:50amTots (6-18m) Friday 9:00amTinies (18m-3yrs) Friday 9:30amMovers (3 & 4yrs) Friday 10:00amTappers (3yrs +) Friday 10:50amMovers (3 & 4yrs) Saturday 9:00amGroovers (4,5-6yrs) Saturday 9:45amPREFERRED START DATE DD slash MM slash YYYY DETAILSCHILD'S FIRST NAME*CHILD'S LAST NAME*DATE OF BIRTH* DD slash MM slash YYYY GENDER* Female Male PARENT/CARER/GUARDIAN FIRST NAME*PARENT/CARER/GUARDIAN LAST NAME*PARENT/CARER/GUARDIAN ADDRESS NUMBER & STREET NAME ADDRESS LINE 2 CITY POSTAL CODE MOBILE PHONE*EMAIL* EMERGENCY CONTACTSEMERGENCY CONTACT 1RELATIONSHIPCONTACT PHONE NOEMERGENCY CONTACT 2RELATIONSHIPCONTACT PHONE NOMEDICAL REQUIREMENTS / NOTIFICATION OF ADDITIONAL NEEDSWILL YOUR CHILD NEED ADDITIONAL SUPPORT FOR ANY REASON? THE SUPPORT MAY BE FOR HEALTH OR MEDICAL REQUIREMENTS, LEARNING DIFFICULTIES OR BEHAVIOUR* YES NO IF YES, YOU WILL BE INSTRUCTED TO GIVE MORE DETAIL LATER IN THIS FORM. WE MAY REQUEST CONFIRMATION FROM YOUR CHILD’S DOCTOR THAT YOUR CHILD IS ABLE TO ATTEND THEIR CLASSES. PARENTAL NOTIFICATION OF ADDITIONAL NEEDSIt is important not to feel that this is making your child different. It is important that we put everything in place to make your child safe, well cared for and happy in class.If you have answered YES to the question above on your application form:– please provide any additional information here:SIGNATUREI acknowledge that I am responsible for my Child’s safety at all times and will ensure that my Child is supervised by a Parent, Carer, Guardian or Authorised Minder at all times and with all babyballet® equipment where applicable.* I agree WHERE DID YOU FIND US?FacebookInstagramGoogle SearchFriends referralBrochure babyballetWebsite babyballetLocal market / Shopping mallClick below to send your enquiry(only click once!)