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To contact us, please fill in the form below.

Student's first name
Student's last name
Date of birth
Parent/Caregiver's Name
Email is our preferred form of communication for & studio notices. Please click on "no" below if you DO NOT want to receive communication by email.
Can we send you emails? yes no
Health - Please list any serious
medical condition/special needs/learning
difficulties that we should be aware
of (eg diabetes, asthma, hearing
difficulties etc):
Class/es for 2017
Previous dance experience, if any
(to enable us to place you in the right class):
By enroling my child at EXTREME DANCE, I accept responsibility for payment of the tuition fees for all classes in which my child is enrolled, and accept the Terms & Conditions of Enrolment as stated in the Studio Information Pack.
I understand that EXTREME DANCE from time to time engages photographers/videographers for studio classes, events & performances, and that any photographs/footage captured may be used for studio purposes including publicity at a later date.
By enrolling my child, I give permission for my child's image to be used.
I agree yes
Office & Studio
5 Paremata Cres,
Paremata, Porirua
PO Box 50-019,
Porirua 5240
Phone: (04) 237 5662
Email: info@extremedance.co.nz
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