Madeline Stuart Dance Company Disco - Madeline Stuart Dance Company

Provider number: 4050039182

Contact Details:

Rosanne Stuart • 0428 156 688 • Email: dance@insideoutsidedance.com

Entry Fee for all Disco Registrations is $20 per participant and $10 for support worker if they request pizza and a drink, support workers are free if they do not want to be included in catering. Those registering and not attending on the night will be invoiced.

Monthly Disco Registration

Please fill out this form each time to register for every month's disco

Name of Participant/s:

Are more than 1 participant registering through the same form?

Yes

If there are multiple participants attending with the same parent/support worker

Phone Number:

Email Address:

Is the participant Gluten Free?

Yes

If multiple participants are registering together and they are Gluten Free, please provide their name/s:

Would the support worker/parent attending like to purchase a drink and pizza for $10?

Yes

If yes, name of Support worker/Parent on the night

Monthly Disco Registration

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