Adult Class Enrolment: Term 1 2025
Monday 3 February - Sunday 13 April Term is underway!
Please email after submitting this form to discuss partial term enrolment options.

Student's Full Name

Pronouns and Preferred Name

Date of birth

Voucher Code

Email address

Physical address:

Contact phone number

Please list all relevant medical conditions, medications, and injuries. (or type "None")
This information is confidential and will only be seen by committee members and instructors.

Previous circus experience

None

<12 months

1-3 years

3+ years

Which areas of circus do you have experience in?

None

Bar apparatus (Lyra/Trapeze)

Fabric apparatus (Silks/Rope/Hammock)

Contortion

Handstands

Prop Manipulation (Juggling, Hula Hoops etc)

Adagio/Partner Acro

Other related activities (Pole/Gymnastics/Dance, etc)

Emergency contact name and relationship

Emergency contact number

Intro to Aerials classes I would like to attend:
Select either a full term (Weeks 1-10) or half term (Weeks 1-5 or 6-10)

Foundation classes I would like to attend:

Hula Hoops: Friday 7.30-8.30pm

Beginner Contortion: Saturday 10.30-11.30am

These classes require experience/instructor approval to attend.
Please email bookings@circotica.com if you new to our studio or would like to check your approval

Name of Acro Partner if attending Play as a duo (they will need to do a form also)

I have read and understood the 'Conditions of Members' document.
I agree to abide by the student conditions and agree to the Student Waiver.

I consent to my photo being taken during
classes and used for promotional purposes

I understand that invoices will be sent the week of Jan 27th- Feb 2nd

Upon submitting this form, I understand that I am enrolled unless informed otherwise, and that any changes to my enrolment must be made within 3 days of submission of this form, otherwise I am liable for the full cost of the class/es.

How did you hear about us?

Social Media (Facebook/Instagram)

Internet Search

Public Event (GapFiller Carnival, Game On Convention, Open Days etc)

Word of Mouth

Other:

Adult Class Enrolment: Term 1 2025 Monday 3 February - Sunday 13 April Term is underway! Please email after submitting this form to discuss partial term enrolment options.

Adult Class Enrolment: Term 1 2025
Monday 3 February - Sunday 13 April Term is underway!
Please email after submitting this form to discuss partial term enrolment options.