Term 1.5
Monday 10 March - Sunday 13 April
Classes run for 5 weeks , price is for the 5 week block
from $120 for Adult and Family classes
from $95 for Kid & Youth classes

Student's Full Name

Pronouns and Preferred Name

Caregiver's Name (for under 18s)

Date of birth

Name of Sibling or Friend for discount

Email address (for billing)

Physical address:

Contact phone number

Please list all relevant medical conditions, medications, and injuries. (or type "None")
This information is confidential and will only be seen by committee members and instructors.

Previous circus experience

None

<12 months

1-3 years

3+ years

Which areas of circus do you have experience in?

None

Bar apparatus (Lyra/Trapeze)

Fabric apparatus (Silks/Rope/Hammock)

Acrobatics - Contortion - Handstands

Prop Manipulation (Juggling, Hula Hoops etc)

Adagio/Partner Acro

Other related activities (Pole/Gymnastics/Dance, etc)

Emergency contact name and relationship

Emergency contact number

Kids & Youth Classes
Approval required for Performance

Kids Mixed Circus 5-8 - 1000-1100 Thursdays

Kids Mixed Circus 8-12 - 1100-1200 Thursdays

Kids & Teens Performance - 1700-1800 Thursdays

Kids Mixed Circus 5-8 - 1100-1200 Saturdays

Youth Beginner Fabrics - 1200-1300 Saturdays

Family Classes
Ages 5+

Family Circus - 1530-1630 Fridays

Family Circus - 930-1030 Sundays

Adult Classes
Approval needed for Beginner Aerials, Rope, and 3 Highs

Beginner Contortion - 1800-1900 Tuesday

Beginner Aerials - 1900-2000 Tuesday

Dynamic Rope - 1800-1900 Wednesday

3 Highs - 1800-1900 Thursday

Beginner Contortion - 1100-1200 Saturday

I have read and understood the 'Conditions of Members' document.
I agree to abide by the student conditions and agree to the Student Waiver.

I consent to my photo being taken during
classes and used for promotional purposes

Upon submitting this form, I understand that I am enrolled unless informed otherwise, and that any changes to my enrolment must be made within 3 days of submission of this form, otherwise I am liable for the full cost of the class/es.

How did you hear about us?

Social Media (Facebook/Instagram)

Internet Search

Public Event (GapFiller Carnival, Game On Convention, Open Days etc)

Word of Mouth

Other:

Term 1.5 Monday 10 March - Sunday 13 April Classes run for 5 weeks , price is for the 5 week block from $120 for Adult and Family classes from $95 for Kid & Youth classes

Term 1.5
Monday 10 March - Sunday 13 April
Classes run for 5 weeks , price is for the 5 week block
from $120 for Adult and Family classes
from $95 for Kid & Youth classes