Audition Form

Medical Conditions
Have you been under the care of a physio / doctor in the last six months?
- Yes
- No
For what condition were you receiving treatment?
Do you have any current injuries?
- Yes
- No
Please give details:
Do you have any allergies / medical conditions?
- Yes
- No
Please give details:
Do you wear glasses or contact lenses?
- Yes - Glasses
- Yes - Contact Lenses
- Neither

Conditions of Enrolment
1. Staff may administer first aid or seek medical attention if required.
2. Students may be photographed or filmed to be used for company publicity or memorabilia.
3. Some physical contact by a member of faculty may be necessary to correct technique and alignment.
4. Parents or friends are not allowed to view classes or rehearsals unless special permission has been given.
5. No responsibility will be taken for students outside of scheduled rehearsal times.
6. Merge Dance Theatre takes no responsibility for any loss or damage to personal property.
7. Fees will be paid by the due date stated on your acceptance form (4 weekly or by the term).
By checking the “I AGREE” box you are agreeing to the terms and conditions of enrolment at Merge Dance Theatre.*
- I AGREE
Name of Parent / Guardian*
CAPTCHA

Applicant Details