Student Enrolment Form 2026

Student Details

Personal Details

Given Names *

Family Name *

Preferred Name

Date of Birth *

Age *

Gender *

MaleFemaleOther

Parents' Names *

Contact Information

Street Address *

City *

State *

Postcode *

Postal Address (if different from above)

Email Address *

Work Phone

Home Phone

Mobile *

Medical Information

Please list any allergies, medical conditions or medications required

Emergency Contact

Full Name *

Relationship *

Street Address *

City *

State *

Postcode *

Work Phone

Home Phone

Mobile *

Legal Notice & Disclaimer

I declare that I am the legal guardian of the above mentioned student /or I am over 18 years of age.

I acknowledge that involvement with the Messinian Association of South Australia Inc. (“the Association”) as the operator of theMessinian Dance School of SA (“the Dance School”) involves participation in a recreational activity which can involve a signifcantdegree of physical exertion or physical risk. The Association and the Dance School is a voluntary not for profit organization and isoperated by volunteers who do not profess any particular skill or qual-ification.

You agree as a condition of the enrolment or involvement that the Association and the Dance School, its instructors, officers,officials, agents and/or employees will not be liable for any loss (including but not limited to personal injury, death, damage to or lossof property) arising from enrolment or involvement with the Dance School and whether any such loss arises from the breach of anycontract or implied contract, negligence or other tort of the Association and the Dance School, its instructors, officers, officials,agents and/or employees or invitees, or your act or omission. Further I agree to indemnify the Association and the Dance School, itsinstructors, officers, officials, agents and/or employees from all such claims and costs.

Signed by Student/ Parent/ Guardian *

Draw signature|Type signatureClear

Date: *

Name of person signing *

Terms & Conditions

PRACTICES & PERFORMANCES:

Prior to performances, students may be required to attend extra practices, this is subject to the instructors’ discretion;
Students must attend a minimum of 5 consecutive lessons prior to any performance unless otherwise organised with instructors;
In case of non-attendance to lesson, students/ caregivers must contact instructors to advise.

UNIFORM & COSTUMES:

All students are to have ownership of a Messinian Dance School branded t-shirt for performance purposes, which must be worn in conjunction of black trousers and black closed shoes;
Any new or replacement t-shirt will incur a cost of $40.00 each;
Traditional costumes are to be issued the week prior to specified performances and returned the lesson following such performance;
Traditional costumes must be washed and all pieces accounted for. Any damages to such costumes will incur a cost subject to the repairs required;
Any lost or unreturned traditional costumes will bear the full cost of replacement to the bearer;
Female students are to have ownership of professional dancing shoes and white stockings for performances (*Subject to instructor discretion);
Proper footwear are to be worn during practices– Instructors hold the right to not permit students to practice if appropriate footwear is not worn;

PROPERTY & MAINTENANCE:

Messinian Association of SA Inc. property is to be respected. Any damages occurred to such property will bear the cost or repairs required; Property includes but not limited to:

Tables & Chairs;
Amenity Facilities;
Car park Facilities.

BULLYING & HARASSMENT:

Everyone has a right not to be bullied or harassed. A person is bullied or harassed if:

A person or group of people repeatedly act unreasonably towards them or a group of people;
The behaviour creates a risk to health & safety;

Unreasonable behaviour includes victimising, humiliating, intimidating or threatening. Examples of bullying and harassment include but are not limited to:

Behaving aggressively;
Teasing or practical jokes;
Pressuring someone to behave inappropriately;
Excluding someone from events;
Unreasonable demands.

Bullying & harassment will not be tolerated and students acting in such manner will be asked to leave the school.

OTHER:

No running in the hall;
No chewing of gum in the hall;
Mobile phones should be turned to silent mode whilst at practice, unless prior arrangement with instructor has been made;
Parents/ Caregivers and Students over the age of 18, permit for photographs and videos to be taken of the students and uploaded to social media such as Facebook for the sole purpose of promoting the Messinian Dance School.

Signed by Student/ Parent/ Guardian *

Draw signature|Type signatureClear

Date *

Name of person signing *

Messinian Association Membership Details

Existing Paid Association Member *

YesNo

Given Names *

Last Name *

Street Address

City

State

Postcode

Payment Details

Dance School Enrolment Fees ($50 per student)- Annual

BSB: 065-124

Acc No.: 10418046

Acc Name: Messinian Association of SA Inc

Reference: (Student Name)

Uniform Fees

BSB: 065-124

Acc No.: 10418046

Acc Name: Messinian Association of SA Inc

Reference: (Student Name)

Association Membership Fees ($15 per family)- Annual

BSB: 065-124

Acc No.: 10135257

Acc Name: Messinian Association of SA Inc

Reference: (Member Last Name)

***Payments can also be made via cash during class times***

Student Declaration and Consent

Student Name *

I declare that the information I have provided to the best of my knowledge is true and correct. I confirm that I have read and understood the information contained in the Student Enrolment Form. I consent to the collection, use and disclosure of my personal information in accordance with the Dance School's Privacy Policy. *

Signature *

Draw signature|Type signatureClear

Date *

Name of person signing *