Enrol at babyballet® Port Moresby

ENROLMENT FORM BABYBALLET PORT MORESBY

CLASSES
PLEASE SELECT YOUR CLASS*
PREFERRED START DATE
DD slash MM slash YYYY
DETAILS
CHILD'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 CONTACTS
EMERGENCY CONTACT 1
RELATIONSHIP
CONTACT PHONE NO
EMERGENCY CONTACT 2
RELATIONSHIP
CONTACT PHONE NO
MEDICAL REQUIREMENTS / NOTIFICATION OF ADDITIONAL NEEDS
WILL 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 NEEDS
It 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:
SIGNATURE
I 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?
Click below to send your enquiry
(only click once!)

ENROLMENT FORM BABYBALLET PORT MORESBY

CLASSES

DETAILS

EMERGENCY CONTACTS

MEDICAL REQUIREMENTS / NOTIFICATION OF ADDITIONAL NEEDS

PARENTAL NOTIFICATION OF ADDITIONAL NEEDS

SIGNATURE

Click below to send your enquiry