BhangraFit Registration

Firstname *

Lastname

Email *

Phone Number *

Address *

Date Of Birth *

Any Special Needs, Alergies, Medications we need to be aware of ? (Please mention them here)

Emergency Contact Name: *

Emergency Phone Number: *

Who is Taking the Classes *

Child's First Name

Child's Last Name

Child's DoB

Card Number *

Expiry: *

CVV *

PayID-
If you would like You can do PayID to save on transaction cost

PayID Details:

Sher Singh- 0409-376-853

Please use "Your Full Name and Class Location" as reference Note: You will receive confirmation on whatsapp once your account is created and payment is received Credit/Debit Card Details are required to enroll you/child for AutoPay. Information will be sent out before accounts are deducted using Credit/Debit Card

Dance/Fitness Level *

Beginner- Never taken any dance classes or fitness classes

Intermediate- I have taken dance classes before or have attended gym or have done fitness in other forms

Advanced- I am active person and looking for different fitness options

Not Taking Dance Classes

Dhol Classes *

Beginner

Inter

Advanced

Not Taking Dhol Classes

How Did You Hear About Us? *

Select an Option

Photo/Video Consent *

Bhangrafit captures and uses photographs and videos of the classes enrolled at Bhangrafit classes for capturing memories which are shared with enrolled families. Bhangrafit may use these images and videos via website activities, social media including official Bhangrafit Facebook page, Youtube, Twitter, Instagram, BhangraFit website, Marketing Material, Newsletter Guidelines in line with privacy and confidentiality requirements that BhangraFit will follow: All images and videos will be of an appropriate nature and will remain in the possession of BhangraFit including approved appointed external photographers and videographers Bhangrafit aims to at all time use the highest level of security for the bhangrafit website currently available. If an image is required to be used for any reason other than what has been stated above, BhangraFit will obtain separate written permission from the parent of the guardian prior to its use

I Consent to Photo/Videos being taken for promotional Use

Injury & Liability Disclaimer Agreement *

I acknowledge, agree and understand that Bhangrafit classes are physical activity that may be hazardous to some individuals, and may result in injury to myself or other dance students. I agree to assume all risks of injury incurred or suffered while attending bhangrafit classes, and release and agree not to sue BhangraFit, its instructors, or anyone connected with the bhangrafit classes for any claim, damages, costs or cause of action which I have or may have in the future as a result of injuries or damages sustained or incurred while attending classes. I agree that first aid measures can be applied in case of an emergency and if necessary, should my emergency contact/Parent be un-contactable, my child/muself will be transported to hospital via ambulance. I also agree to notify the dance teacher if any illnesses or injuries are sustained to my child or myself outside of classes so that all care can be taken.

I have read and agree to the injury & liability disclaimer

Safety Declaration and Consent *

Agree to accept all BhangraFit policies and procedures. Declare that the information on this enrollment record is true and correct and undertake to immediately inform the service in the even to any change to this information. Give authority for BhangraFit and authorized engaged professionals to capture and use images and videos of as outlined above.

I declare that all information provided is correct to my knowledge at the time of registering and agree to all the instructions given to me by the instructor in the class

BhangraFit Registration

BhangraFit Registration

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