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Registration Form
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Student Name:
D.O.B:

School Year:

Age:

School Attend:
First Parent/Guardian

Second Parent/Guardian

Name:

Name:

Relationship to the Student:

Relationship to the Student:

Contact Number:

Contact Number:

Email Address:

Email Address:

Address:

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Address:

Class wishing to sign up for is: Just Junior Dance (School years 3 to 6)
(Please delete where appropriate)

Please note:

If your registering for Just Junior

Dance you will be added to a waiting
list and contacted in November to
conform your place to start in January.

Yes / No

(Includes: Modern, Tap, Ballet & Street)

Super Senior Dance (School years 7 plus & Adults)

Yes / No

(Includes: MTV Modern, Tap, Contemporary & Choreography)

Theatre (School years 7 plus & Adults)

Yes / No

Questions
Is there any medical issues we need to be
aware about regarding the student?
Does the student have any disabilities we need
to be aware of?
Do you give permission for us to take photo of
the student to help promote OLSENtdc?
Has the student had previous dance or theatre
experience? If yes, please explain where.

Payment for classes are termly, how do you wish Cash / Cheque / Bank Transfer
to pay for them? (Please delete where appropriate)
Thank you for filling out this form. Please save this as either a word document or PDF file and send to
olsentdc@hotmail.com. You will receive an email within 5 working days to confirm your/students place at
OLSENtdc. If you are not emailed within this time or have any questions please feel free to contact us via
the same email address or contact Willis George Olsen directly on 07740062838. Just to remind you by
registering you are also signing up for our trail day which is on FRIDAY 5TH AUGUST. For more
information regarding the trail day please visit our website or contact Willis.
Kind Regards
Willis George Olsen
OLSENtdc Company Director