Participant Details / Date:
Name / Email
Age / Date of Birth / GenderMaleFemale
Suburb
Phone / Current School
Which Terms would you like to attend? / Term 1 / Term 2 / Term 3 / Term 4 / Holiday Week 1
Holiday Week 2
How did you hear about us? / Google / School Newsletter / BYT Website / Friend / Other (please specify)

Emergency Contact Details

Name / Phone No.
Relationship to Participant
Details
Does your child have any allergies? / NO / YES
Is your child taking any medication? / NO / YES
Do you have any access requirements? / NO / YES
Does your child have a learning difficulty? / NO / YES

Terms of Enrolment

  • Attendance at workshops can only be confirmed once payment has been received. Payment is a prerequisite to commencing classes.
  • Once the attendance has been confirmed, no refund or cancellations will be allowed.
  • Brisbane Youth Theatre does not accept liability for any personal injury, unless the cause of the injury is found to be negligence on the part of a Brisbane Youth Theatre employee.
  • Brisbane Youth Theatre has the right to terminate a child’s attendance at classes if a child’s behaviorsignificantly impacts the rest of the class detrimentally. A senior facilitator will place a phone call to parent or guardian for immediate collection of child.
  • Brisbane Youth Theatre does not accept responsibility for any personal property left at the venue.
  • All personal information that you give to Brisbane Youth Theatre, including the information on this form is used in accordance with our privacy policy. You can view this policy on our website: or contact us if you would like a copy sent to you.

CONSENT
Brisbane Youth Theatre sometimes film workshops, rehearsals and performances.
These images and recordings may be used by Brisbane Youth Theatre for publicity, on our website and in our brochures.

No names will be used. Image = photograph or film Voice = recording of talking, singing or performing

Do you agree to your image or voice being used by Brisbane Youth Theatre?

YES Brisbane Youth Theatre CAN use my image or voice

NO Brisbane Youth Theatre CANNOT use my image or voice

Do you understand both the Terms of Enrolment and Consent sections of this form?

YES

NO

Guardian’s Name / Please type your email address here again to confirm your acceptance

Cost

9 Week Term / Age 7 – 11 $188.00* 1hr class
9 Week Term / Age 12 - 17 $258.00* 1.5hrs class *10% family discount applies for subsequent siblings
Holidays / 4 Days $258.00

Which Time?

Paddington
Monday 4pm - 5pm ages 7 – 9
Monday 5pm – 6pm ages 9 – 11
Thursday4pm – 5pm ages 9 – 11
Thursday 5pm – 6:30pm ages 12 – 17

Please complete and send this enrolment and your remittance to

PAYMENT METHOD – ELECTRONIC FUNDS TRANSFER**
Account Name: / Brisbane Youth Theatre
BSB: / 084 385
Account Number: / 644513215
Description: / Please enter the participants’ name and surname in description on transfer details.
ie. jacksmith
Brisbane Youth Theatre © 2018 / Page 1 of 2