Secured a spot in one of our upcoming workshops?

You can fill out this form online to save you time on the day.

Questions? Get in touch with us at elena@dancedomain.com.au

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[contact-form][contact-field label=”Student Name (First & Last)” type=”name” required=”1″ /][contact-field label=”Date of Birth” type=”text” required=”1″ /][contact-field label=”Parent/Caregiver Name” type=”text” required=”1″ /][contact-field label=”Parent/Caregiver Phone” type=”text” required=”1″ /][contact-field label=”Parent/Caregiver Email” type=”text” required=”1″ /][contact-field label=”Address” type=”text” required=”1″ /][contact-field label=”Emergency Contact Name” type=”text” required=”1″ /][contact-field label=”Emergency Contact Phone Number” type=”text” required=”1″ /][contact-field label=”Please list any pre-existing medical conditions” type=”textarea” /][contact-field label=”Please list any pre-existing injuries” type=”textarea” /][contact-field label=”Please list any known allergies” type=”textarea” /][contact-field label=”Acknowledgement of Terms and Conditions (see below)” type=”select” options=”I AGREE that I have read and acknowledged the terms and conditions as outlined below,I DO NOT AGREE to the terms and conditions as outlined below” required=”1″ /][/contact-form]

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T&Cs

ATTN: PARENT/GUARDIAN(S) – PLEASE READ AND ACKNOWLEDGE

By completing this release you are acknowledging and giving Dance Domain Studios Pty. Ltd. permission to use your child’s likeness in any publication, photograph, website, brochure, video, advertisement or other promotional material(s) solely within the scope of publicising the business.

I have chosen to allow my child to participate in dance instruction and activities given by Dance Domain Studios Pty Ltd. I acknowledge that I understand the nature of the activities my child will partake in and the possibility that despite precautions, accidents and/or physical injury may occur. I voluntarily agree, therefore, to assume all risks and responsibility for any such accident or injury which might occur to me or my child during any of the Dance Domain Studios Pty Ltd classes, workshops, rehearsals, performances, workshops or activities. I also exempt, release and indemnify Dance Domain Studios Pty Ltd, its owners, employees, faculty members and/or students from any and all liability claims, demands or causes of action whatsoever from any damage, loss or injury to me, my child or property which may arise out of or in connection with participation in any activities conducted by Dance Domain Studios Pty Ltd. I understand that I should be aware of my physical limitations and agree not to exceed them. If I am signing this waiver for my child, I certify that I am the parent or legal guardian and have the right to waive these rights. By agreeing to this I am acknowledging that I am fully informed of the contents of this release and have read the terms and conditions outlined above. My agreement is proof of my intention to execute a complete and unconditional waiver and release of all liability pursuant to the terms herein and agreement as to all terms and conditions contained above. I am of lawful age and competent to sign this affirmation.