Polecatz Australia Dance Fitness Studios

POLE CATZ AUSTRALIA DANCE FITNESS STUDIOS

REGISTRATION FORM

NAME*
ADDRESS*
SUBURB*
STATE AND POSTCODE
CONTACT NUMBER*
EMAIL*
DATE OF BIRTH
EMERGENCY CONTACT NUMBER:

How did you hear about us ? *
Past dance/fitness training ? *
Pre existing condtions ?*

REASON FOR ATTENDING CLASS	Fun and Fitness
	To enter the Industry as an instructor or dancer
COURSES and CLASSES
COURSE and CLASSES: Pole Dance Course Burlesque Course Ballet Fit/Flexist/Yoga Lapalicious Pole Fitness Class	Zumba Fit Class Aerial/Aerial Dance Course Yummy Mummies Pole Class Pole Grooves Class Pole Tricks Pole Addicts Bikini Bootcamp		COURSE LEVEL: DAY OF THE WEEK:
VENUE:*	Byron Bay Tweed GCBundall GCMmdBch Lismore
Commencement Date & Time Preffered:
CASUAL ATTENDANCE at $15.00 per session (one class)
5 sessions for $65.00		10 sessions for $100 (valid all casual classes)

PRIVATE TUITION
Aerial /Pole/Personal Training at $60.00 per session (1 x hour)		or 5 for $250.00

6 WEEK COURSE Paid upfront $130.00 ( includes 6 sessions plus attendance to 1 practice session).		6 WEEK COURSE pay as you go ( $60 deposit then 4 installments of $20) $140.00
6 WEEK MEMBERSHIP Paid upfront $200		or 6 debits of $33.00 - $35.00 deposit
DELUXE MEMBERSHIP 12 week commitment Paid upfront $320.00		or 12 debits of $28.00. $28 deposit

Please read the terms and conditions before going further.Terms and Conditions pdf file. I have read and understood and accept the terms and conditions of class participation. I am over the age of 18 or have my parents/guardian's concent. Please fil out their name and contact number below. Type in Yes
if under 18 - Name of Parent or Guardian Contact Number:
Would you like to receive our class updates and product specials by email ? Yes No
On submit of your registration form you will be taken to the payment page for secure PayPal payment.. or Bank Transfer to Polecatz: BSB 012554 ACC 490936396. For Credit Card Payments over the phone please contact us on 0468 35 CATZ (2297). Your Booking will not be finalised until a min $50 deposit is made. Thank you and looking forward to having you along!