Enrolment Form

Student Details No. 1

Surname:   Given Name:
Address:   Suburb:
      Postcode:
Education
(Name of School):		      
DOB:      
Any Other Information (eg. learning difficulties, hyper activeness, vision/hearing impairments):

 

Student Details No. 2

Surname:   Given Name:
Address:   Suburb:
      Postcode:
Education
(Name of School):		      
DOB:      
Any Other Information (eg. learning difficulties, hyper activeness, vision/hearing impairments):

 

 

Parents/Guardian (Responsible for fees)

Title      
Surname:   Given Name:
Address:   Suburb:
      Postcode:
Email:      
Phone (Home):   Phone (Work):
Mobile:   Fax:
Relationship to Student:

 

 

Emergency Contact

Family Doctor:   Contact no.:
Emergency Contact if unavailable to contact parents/guardian
Phone (Home):   Phone (Work):
Mobile:   Fax:
Relationship to Student:

 

 

Enrolment: Class/Day/Time

  Student Name   Class   Day   Time
1.      
2.      
3.      
4.      

 

 

I wish to enrol my son/daughter at the Manhattan School of Music and accept that classes attended are at his/her/their own risk and that Manhattan School of Music accepts no liability for injury or loss to him/her/them under any circumstances. I/we have further read and accept the enrolment terms and conditions outlined by Manhattan School of Music and agree to meet all payment requirements. (Enrolment terms and conditions attached for your information). We also give permission that any photographs of my child/children taken because of their association with the Manhattan School of Music may be used for publicity in any advertising media.