2017 Dance Parents

Please fill out the form below then press submit only once.

Dance Parents Enrolment Form

Name

First Name

Last Name

Select a class

Prices are per term

PYT Dance Parents Weds 6.30 to 7.30pm $149

I will be accompanied by a beautifully behaved child with some homework to finish while I have fun

Mobile

Emergency number - if different from above

Amount Paid / To Be Deducted

Classes always commence Week 2 of the School Term.

Payment Method

Please note new account details below

Internet Transfer Direct Deposit into: Bank of Queensland BSB 124001 A/c No. 22240389 Platinum Entertainment (WA) Pty Ltd

Visa/Mastercard (No Surcharge)

Bartercard/BBX

Cash

Card Details

Enter Credit or Bartercard/BBX number - Expiry Date - Name on card

Notes

Any questions? Medical conditions or anything else we need to know

Permission to use photographs

Please tick the box below to allow us to use photographs for publicity purposes only

Yes, I agree

Terms and Conditions

Tick to agree to our T's & C's

Submit details