LITTLE GLIMMERS

PRESCHOOL PROGRAM

PARENT/CARER INFORMATION

Email *

First Name

Last Name

Phone *

Address *

Street Address

City

State

Country

Postal Code

Emergency Contact *

Someone other than the parent/carer enrolling

STUDENT INFORMATION

Student First Name *

Student Last Name *

Date of birth *

Gender

If you would rather not note this - please type N/A

Any Medical Conditions or allergies? If so please list

Additional Needs

Tell us how we can help your child to make class time as productive & comfortable as possible

T-Shirt Size (Little Glimmers) *

CLASS INFORMATION - Enrolment Request

Studio Location *

Classes Available - GLOWBUGS - "Dance With Me" - 12mths to 2 yrs

RUTHERFORD: WEDNESDAY... 10.00-10.30am

RUTHERFORD: THURSDAY... 2.45-3.15pm

RUTHERFORD: SATURDAY... 10.30-11.00am

Leave Blank If Not Applicable

Classes Available - MOONBEAMS - 2 to 3.5 yrs

RUTHERFORD: MONDAY... DANCE 3.30-4.00pm

RUTHERFORD: MONDAY... CIRQUE & TUMBLE 4.00-4.30pm

RUTHERFORD: TUESDAY... CIRQUE TUMBLE 4.00-4.30pm

RUTHERFORD: WEDNESDAY… DANCE 3.45-4.15pm

RUTHERFORD: SATURDAY… CIRQUE & TUMBLE 10.00-10.30am

RUTHERFORD: SATURDAY… DANCE 10.30-11.00am

GRETA: MONDAY... CIRQUE & TUMBLE 4.00-4.30pm

GRETA: WEDNESDAY… DANCE 3.45-4.15pm

Terms & Conditions

I have reviewed and agree to terms & conditions provided by Galaxy Talent Academy (link is below). By providing my phone number, I agree to receive text messages from Galaxy Talent Academy.
Terms & Conditions can be found HERE

Galaxy All Inclusive Pricing

View our Pricing Here:

https://drive.google.com/file/d/1Os80gx5lb_OuaaaQ7QCXon5lUM5Jt2_t/view?usp=share_link

I have read and understood the All Inclusive Pricing Policy set by Galaxy and agree to the resulting charges of my enrolment

Photo Release

Please choose one of the following options *

FULL PHOTO RELEASE - I acknowledge and consent to allow Galaxy Talent Academy to use photos and/or videos of my child/myself in publications (such as flyers/brochures), advertisements (such as newspapers or online ads), our studio’s website, or on social media sites (such as the studio’s facebook or instagram account). I understand that in some cases, my child and/or my first name only may be used. I also consent to videos and images of my child appearing in Galaxy's Band App

PARTIAL PHOTO RELEASE - I consent to my child being photographed and/or video footage taken for the purposes of Galaxy's in house Band App only

NO CONSENT - I do NOT consent for any photos to be take of my child and understand that they will be asked to step out of any photographs or video footage that is recorded.

ENROLMENT FEE PAYMENT

This is required to secure your place in classes, please click on the amount below to proceed *

AU$ 50