Perry Studio - Enrolment Form - Children Student Details * First Name Last Name Email * Address * Mobile * Date of Birth * MM DD YYYY Parent/s Details ( required for students under 18 years) First Name Last Name School and Grade Medical Concerns ? No Yes If YES please provide details How did you hear about Perry Studio? Primary reason for attending Speech and Drama class Media Authorisation Release and Consent * Perry Studio has my permission to use photos and video of my child/children in classes. I understand that the images may be used in print publications, online publications, presentations, websites and social media. I also understand that no fee shall be payable to me by reason of such use. I confirm that this consent is voluntary and can be withdrawn at any time by providing written notice to Perry Studio. Yes No Thank you! * required