Pre-Primary Enrol

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PRE-PRIMARY ENROLMENT FORM

DANCER INFORMATION

Dancer - First Name

Birthday

Dancer - Last Name

Medical conditions or information we should know?

CONTACT INFORMATION

Parent/Guardian Full Name

What’s your phone number?

What’s your email address?

EMERGENCY INFORMATION

Please add any emergency contact details in case we are unable to contact the primary guardian.

Contact Us

217 Great Southern Road

Bargo NSW 2574

Tel: 02 4684 2891

THE BLOC DANCE ACADEMY