ENROL | Epic Motionz Dance

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*Please complete one form per student

Students Full Name

First Name

Last Name

Students Date Of D.O.B (Date of Birth)

Enrolment Status

Parent/Guardians Name

Parent/Guardians Phone Number

Parent/Guardians Email

Class Enrolment*

Classes Available

Specify Classes you would like to Enrol in

(This is not final, students will be assessed and placed into class by current abilities)

Contact us for any questions or concerns and if you are not sure of which class

Select Classes

HIP HOP 5-6 Yrs

HIP HOP 7-8 Yrs

HIP HOP 9-10 Yrs

HIP HOP 11-12 Yrs

HIP HOP 12 Yrs & Up

JAZZ 5-6 Yrs

JAZZ 7-8 Yrs

JAZZ 9-10 Yrs

JAZZ 11-12 Yrs

JAZZ & CONTEMPORARY 12 Yrs & Up

I agree to the terms & conditions. (This includes photo permission of student, liability etc.)View terms

Thank you for your enrolment! We will contact you soon.

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30 Waiora Road, Stanmore Bay, Auckland | jenny@epicmotionzdance.co.nz | 021 026 21373

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