Dancer Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Parent/Guardian Name (if applicable)

Required for dancers under the age of 18 years.

First Name

Last Name

Media Consent

During classes, we capture footage of dancers to share with our audience online and on social media platforms. There is no obligation to be filmed or photographed. Please select the appropriate option below:

No, I do not wish to be filmed or photographed.

Yes, I do consent to be filmed and/or photographed by Dance Conservatory Australia. I understand that this material may be used in various publications, or for other related endeavours.