Student information First Name* Last Name* Date of Birth* New or returning student* New student Returning student Instagram handle Contact details Parent/Guardian 1 - name* Parent/Guardian 1 - telephone* Parent/Guardian 2 - name Parent/Guardian 2 - telephone E-mail* Street Address* Suburb* Postcode* Medical conditions Allergies/Conditions* Yes No Injuries (previous or current)* Yes No If yes, please provide details Enrolment details Classical Ballet Primary (5,6yrs) - Monday 3.30pm Primary (5,6yrs) - Thursday 3.30pm Grade 1 (7yrs) - Tuesday 3.30pm Grade 1 (7yrs) - Friday 3.30pm Grade 2 (8yrs) - Tuesday 4.15pm Grade 2 (8yrs) - Friday 5pm Grade 3 (9yrs) - Tuesday 5pm Grade 3 (9yrs) - Thursday 3.45pm Grade 4 (10yrs) - Tuesday 6pm Grade 4 (10yrs) - Friday 7.45pm Intermediate Foundation - Tuesday 4.30pm Intermediate Foundation - Thursday 5pm Intermediate Pointe - Tuesday 5.30pm Intermediate - Tuesday 6pm Intermediate - Wednesday 4pm Advanced Foundation- Tuesday 8pm Advanced Foundation - Wednesday 5pm Advanced Pointe - Tuesday 7.30pm Advanced 2 - Monday 7.15pm Advanced 2 - Wednesday 5.45pm Jazz Jazzy Juniors (5-6yrs) - Monday 4.00pm Boppin Juniors (7-9yrs) - Monday 4.00pm Junior Jazz (10+) - Monday 4.30pm Tap Level 1 Tap (4,5yrs) - Tuesday 4.00pm Level 2 Tap (6yrs) - Tuesday 5.30pm Level 3 Tap (7yrs) - Tuesday 5.00pm Level 4 Tap (8yrs) - Tuesday 4.30pm Level 5 Tap (9yrs) - Thursday 4.30pm Level 6 Tap (10yrs) - Tuesday 6.30pm Level 7 Tap (11yrs) - Thursday 7.45pm Level 8 Tap (12yrs) - Tuesday 8pm Level 9 (13yrs) - Tuesday 6pm Hip Hop Junior Hip Hop (6-9yrs) - Monday 4.30pm Intermediate Hip Hop (10+yrs) - Monday 5pm Stretch (Strength & Conditioning) Sub Junior Stretch (4-6yrs) - Thursday 4pm Junior Stretch (7-10yrs) - Friday 5.45pm Intermediate Stretch - Thursday 6.45pm Senior Stretch (12+yrs) - Wednesday 6.45pm Senior Technique (13+) - Monday 6.30pm Acrobatics Mini Acro (4-6yrs) - Saturday 12pm VLDA Performance troupes Is the student a member of VLDA's performance troupes?* Yes No If yes, which troupes does your dancer currently perform in? 6U Performers - Thursday 4.30pm 8U Performers - Friday 4pm 10U Performers - Thursday 6pm 10U Performers - Friday 6.45pm 12U Performers - Monday 6pm 12U Performers - Monday 7pm 14U Performers - Monday 7.45pm 14U Performers - Wednesday 5.45pm 16U Performers - Monday 8.30pm Open Performers - Wednesday 8.30pm 10U Tap Performers - Thursday 5pm 12U Tap Performers - Tuesday 7.30pm Open Tap Performers - Tuesday 7pm 12U Hip Hop Performers - Monday 5.30pm Open Hip Hop Performers - Wednesday 7.45pm Private lessons Are you interested in private lessons? Yes No Enrolment feesPlease note: All families are required to pay a yearly administration fee upon enrolment. If you have more than one child dancing at VLDA, please select the family rate. All private lesson students are also required to pay an additional $25 per year, per dancer. This fee covers APRA, PPCA and copyright fees. No discounts apply for private lesson enrolment fess. These fees will be added to your first invoice of the year. Adminstration fee* Individual - $65 per dancer; or Family - $95 per family Private lesson enrolment fee Additional $25 per dancer (no discounts apply) Release and Waiver The above information is true to the best of my knowledge. I understand that dance instruction requires physical exertion. I also acknowledge that injury may result during instruction, including but not limited to, as a result of physical contact with other students, instructors, fixed or movable objects, or the condition of the floor. I represent that I am medically and physically able to safely participate in dance classes, workshops, rehearsals and performances, and to meet the physical demands thereof. If at any time I have any medical or physical limitations, or a condition that may affect my ability to safely participate in dance classes, workshops, rehearsals, photo shoots or performances, I will make such limitations and conditions immediately known to Vanesa Lee Dance Academy. In view of the foregoing, and as a term and condition of receiving dance instruction from Vanessa Lee Dance Academy, I expressly release, waive and discharge Vanessa Lee Dance Academy, its officers, directors and employees from all present and future claims, demands, actions, judgments, executions, and liabilities of any kind. I understand that no staff supervision will be provided in waiting rooms, bathrooms, empty studios and the carpark, and that if I choose to leave my child unsupervised at the studio, I do so at my own risk. I give permission to receive medical assistance if required, such as bandaids, ice packs, ventolin or panadol when requested by my child, and agree that I am liable for any costs associated with medical assistance, including but not limited to, transport by ambulance. I give permission to be photographed and/or filmed during classes, workshops, rehearsals and performances, and for said images and video footage to be used by Vanessa Lee Dance Academy for marketing purposes, both online and in print. I hereby represent that I am the guardian of the participating student and that I will abide by all terms and conditions as set out by Vanessa Lee Dance Academy, including the above release and waiver.* Yes How did you hear about the Vanessa Lee Dance Academy? Returning student Word of mouth Internet search Dapto Flyer Facebook Instagram Other Submit enrolment off