2018 YARRAM CAMPUS CONCERT PARTICIPATION FORM

NOTE: Fees are non-refundable. Use one form per family.
Please note concert forms will NOT be accepted if there are still fees owing from Term 3. Term fees MUST be paid first.

Student name(s):   

Parent/guardian name:   

Please select your answer from the boxes below:

I/we will be participating in the 2018 concert.

I/we understand that it is compulsory to attend dress rehearsal on Saturday 1st December and I/we have recorded this date.

I consent for my child/ren to be included in photographs taken by Leaps and Bounds and used in media.

Concert participation fee
A fee is required for each class a student is enrolled in.

Number of classes x $20.00ea 

Concert ticket orders
Fill out the below if you wish to order concert tickets in advance.

Child ticket 15yrs and under x $10.00ea   

Adult ticket 16yrs and over x $15.00ea  

TOTAL BEING PAID:        

PAYMENT DETAILS
(if Visa or MasterCard not provided then an invoice will be emailed to you instead)
Card type
Name on card
Card number
Expiry date (mm/yy)
CCV Number