Name *

Student 1

First Name

Last Name

Date of birth

MM

DD

YYYY

Name

Student 2

First Name

Last Name

Date of birth

MM

DD

YYYY

Name

Student 3

First Name

Last Name

Date of birth

MM

DD

YYYY

Name

Student 4

First Name

Last Name

Date of birth

MM

DD

YYYY

Name - Parent/Caregiver 1 (student if over 18) *

(if student under 18)

First Name

Last Name

Mobile number - Parent/Caregiver 1 or Student if over 18 *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name - Parent/Caregiver 2

First Name

Last Name

Mobile number - Parent/Caregiver 2

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact *

First Name

Last Name

Emergency contact phone number

(###)

###

####

Student 1 - Allergies or Medical Conditions?

YES

NO

Student 2 - Allergies or Medical Conditions?

YES

NO

Student 3 - Allergies or Medical Conditions?

YES

NO

Student 4 - Allergies or Medical Conditions?

YES

NO

Permission to take photographs/videos of student(s) for Greek Lyceum private use only eg. Concert Program, School Booklets, Costume tags, etc

YES

NO

Photographs and video footage of performances and classes are used on our website, social media accounts and advertising materials. We do not name the students who appear in these photographs or videos. Do you consent to the use of photograph and video footage of the student(s)? *

YES

NO

Does the student have dance experience from a previous Greek dance group or Greek school?

YES

NO

Acknowledgement - (caregivers to mark acknowledgement on behalf of students under 18) *

Students enrolled and performing with the Lyceum are expected to perform only with the Lyceum and not with other Greek dancing groups or schools. Exceptions include but are not limited to involvement in mainstream school groups, those connected with Greek language schools and regional groups (Σύλλογοi) where performances are once-off and involvement is not ongoing. Families and students are asked to declare involvement in other Greek dance groups so consideration may be given to the appropriateness and practicality of enrolment with the Lyceum.

Acknowledge