WILCARINA YEATES
.R.A.D    P.D.B
L.I.S.T.D
RAD RTS
Tel: (011) 764-1541
Cell: 072 238 3234

ANNEBELLE HERBST
L.R.A.D   A.I.D.T
L.I.S.T.D
RAD RTS
Tel: (011) 958 2744
Cell: 082 958 9109

ENROLMENT CONTRACT


 

FULL NAMES OF LEARNER………………………………………………………………………………………………………….

 

LEARNER’S DATE OF BIRTH………………………….SCHOOL LEARNER ATTENDS………………………………………..

 

LEARNERS CELL NO (IFF APPLICABLE)………………………………………………………………………………………….

 

RESIDENTIAL ADDRESS OF LEARNER………………………………………………………………………………………………

 

…………………………………………………………………………………………………….CODE……………………………….

 

POSTAL ADDRESS…………………………………………………………………………………………………………………….

 

…………………………………………………………………………………………………….CODE………………………………

 

MOTHERS NAME & SURNAME………………………………………………….MOTHERS CELL………………………………

 

MOTHERS BUSINESS TEL………………………MOTHERS EMAIL……………………………………………………………..

 

FATHERS NAME & SURNAME………………………………………………….FATHERS CELL………………………………..

 

FATHERS BUSINESS TEL………………………..FATHERS EMAIL……………………………………………………………..

 

NAME OF PERSON RESPONSIBLE FOR ACCOUNT……………………. ……………. HOME TEL NO………………………

 

NAME AND CONTACT NUMBERS OF PERSON RESPONSIBLE FOR TRANSPORTING CHILD e.g. MOTHER, GRANNY, AU PAIR, KIDS TRANSPORT, ETC

 

……………………………………………………………………………………..ARE PARENTS DIVORCED? YES / NO

 

IN ORDER TO ASSIST US IN TEACHING YOUR CHILD WITH CARE AND UNDERSTANDING, PLEASE GIVE DETAILS OF ANY MEDICAL/ REMEDIAL/ EMOTIONAL INFO THAT WE NEED TO BE AWARE O, & STATE MEDICATION, IF ANY (e.g. asthma, epilepsy, allergies, ADD, ADHD, visual, hearing, or if child has received occupational, speech or remedial therapy)

                                                                                …………………………………………………………………………………….

 

I understand that as per this contract, fees are payable per term, within the 1st month of each term, & that interest will be charged on fees more than one term in arrears.

I accept that one term’s written notice (no sms  )is required to discontinue lessons.

I understand that the art of Dance is both visual & physical. Therefore appropriate personal verbal correction & physical contact will be applied during instruction.

I irrevocably indemnify the contractors, venues & teachers of Wilcarina & Annebelle’s School of Dancing against any liability whatsoever in respect of injury which may be sustained by my child as a result of participation in the dance programme.

 

………………………………………………                                        …………………………

Signature of parent/guardian                                                                Date.

 

I HEREBY GIVE/don’t give PERMISSION FOR DANCE RELATED PHOTOS/VIDEOS OF MY CHILD TO BE POSTED ON WILCARINA & ANNEBELLE’S WEBSITE / FACEBOOK PAGE.

 

…………………………………………..SIGNATURE (PARENT/GUARDIAN)     ……………………………..(DATE)