ONLINE ENROLMENT - KINDERGARTEN TO ADULT CLASSESRETURNING STUDENTS HVT Enrolment Form - School Age - Adult RETURNING STUDENTS HVT STUDIO OF PERFORMING ARTS*2021 ENROLMENTClasses* Tap Ballet Jazz (must be enrolled in a Ballet class) Contemporary/Lyrical (must be enrolled in a Ballet class) Hiphop Acro & Stretch Adult Tap Adult Combo Class Eisteddfod Private Lessons Tap Ballet Jazz Contemporary/Lyrical Exam Private Lesson Tap Ballet Student Type* Returning Student Please indicate your agreed lesson days & times (if known) Student Name* First Last Date of birth* DD slash MM slash YYYY Address* Street Address Suburb State / Province / Region Post Code Student Mobile No (if any)Student Email (if any) Emergency ContactsContact Name 1* First Last Relationship* Mobile No*Email* Contact Name 2 First Last Relationship* Mobile No*Email* Payment Type* Full Term Payment by Week 1 (25% Discount) Weekly Total $ 0.00 Billing address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Credit CardCard Details Cardholder Name Terms & ConditionsFees can be paid by direct deposit only using one of the two options - weekly or by Term. Students enrolled at HVT are not permitted to attend classes at another dance studio establishment. All lessons enrolled in and missed must be paid for. No refunds, discounts or credits will be given for any missed classes due to illness or holiday. No refunds for change of mind. Term fees not paid in full by week 1 will be charged at the weekly rate. This is to be set up as a weekly regular direct debit. Fees not paid within 2 weeks will result in termination of tuition. Four weeks notice must be given in writing to cancel any lessons currently enrolled in. Lessons will then be forfeited. Upon termination of tuition all music, routines, choreography and images (photographic & video) remain the property of HVT Studio of Performing Arts. If there is a pro-longed injury or illness i.e. Duration of 3 weeks or more a credit is eligible after presenting a doctors certificate. Injury/Medical Condition & Consent It is the students/parents responsibility to inform their teacher of any injuries/medical conditions prior to class commencing. In the event of a medical emergency, and where a parent or guardian cannot be notified, I authorise HVT Studio of Performing Arts to seek medial advice. I acknowledge that with any physical activity there is a risk of personal injury involved. I understand that HVT staff members take the utmost care to provide a safe dance experience and neither HVT or it’s teachers are responsible or liable for any injury/accident that may occur. Alergies or learning difficulties to be aware ofMedia ConsentStudents at HVT Studio of Performing Arts may be photographed or filmed and these photo’s may be used for promotion purposes in newspapers, magazines, webpage’s and social media. If you don not wish for the students photo or footage to be used then please advise below;Do you give permission?* Yes I do not give permission IF YOU ARE VIEWING CLASS THROUGH OUR VIEWING WINDOWS OR IN THE ROOM, RECORDING FROM MOBILE PHONES OR ANY OTHER PHOTOGRAPY IS STRICLY PROHIBITED.Parent/Guardian E-Signature* Write down full nameClick the checkbox if you have read and agree to the terms & conditions.* I agree Date* MM slash DD slash YYYY Active Kids and Creative Kids Vouchers (school age children)* I am submitting my Active Kids Voucher to use towards tuition I am submitting my Creative Kids Voucher to use towards tuition I won't be using my vouchers N/A Please forward a copy of the voucher you would like to use at the time of submitting this enrolment to email@example.comACTIVE KIDS VOUCHER DETAILS - VOUCHER NUMBER PLEASE CREATIVE KIDS VOUCHER DETAILS - VOUCHER NUMBER PLEASE Receipt number of transfer for registration.*2021 Registration fee of $35.00 is required at the time of submission otherwise your enrolment will be void. Please transfer into the HVT account and write the receipt number below before you press submit.NameThis field is for validation purposes and should be left unchanged.