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REGISTRATION 2017/2018

 

DANCER INFORMATION
PARENT/GUARDIAN INFORMATION
(LEAVE BLANK IF DANCER IS 18+)
FIRST NAME FIRST NAME (PRIMARY)
LAST NAME LAST NAME
BIRTHDAY MONTH            CELL PHONE
  DAY                          
  YEAR (EX: 2008)   FIRST NAME
PLEASE NOTE ANY
ALLERGIES OR
LEARNING DISABILITIES
LAST NAME
    CELL PHONE
       
CONTACT INFORMATION CONTACT INFORMATION
(CHECK IF SAME AS DANCER)
STREET STREET
CITY CITY
POSTAL CODE POSTAL CODE
PROVINCE PROVINCE
PHONE NUMBER PHONE NUMBER
CELL PHONE NUMBER    
EMAIL
NEWSLETTERS WILL NOW BE EMAILED TO ALL DANCERS.
PLEASE INCLUDE ALL EMAILS THAT SHOULD HAVE ACCESS TO DANCER UPDATES.
IF MORE SPACE IS REQUIRED, PLEASE SEE US AT THE STUDIO
EMAIL ADDRESS 1 - PRIMARY EMAIL
RELATIONSHIP
EMAIL ADDRESS 2
RELATIONSHIP
EMAIL ADDRESS 3
RELATIONSHIP
DANCE CLASS INFORMATION
DID YOU RECEIVE A NOTICE TELLING YOU WHICH CLASS YOU SHOULD BE ENROLLED IN?

YES, I AM IN

YES, BUT I WOULD
LIKE TO CHANGE
(PENDING DANCEABILITY APPROVAL)

NO, BUT I SHOULD HAVE RECEIVED A NOTICE

NO, I AM A NEW STUDENT

PAYMENT INFORMATION
REGISTRATION MUST BE PAID IN FULL BEFORE ANY SPOT WILL BE HELD.
$32 FOR REGISTRATION, $20 FOR EVERY SIBLING

PAYMENT OPTIONS INCLUDE:
MONTHLY POST DATED CHEQUES
AUTOMATED MONTHLY CREDIT CARD CHARGE
E-TRANSFER
FULL PAYMENT - CASH, CHEQUE, CREDIT CARD, DEBIT - 10% DISCOUNT
       
   POST DATED CHEQUES - ALL CHEQUES MUST BE RECEIVED ON THE FIRST DAY OF CLASS
  MONTHLY CREDIT CARD CHARGE
NAME ON CARD
NUMBER
EXPIRY  (EX: 02 12)

CIV#
 I WILL E-TRANSFER PAYMENT IMMEDIATELY TO DANCERSCHASSE@ROGERS.COM
   FULL PAYMENT - ALL PAYMENTS MUST BE RECEIVED ON THE FIRST DAY OF CLASS
OTHER NOTICES
I UNDERSTAND THAT THE OWNER | INSTRUCTORS | STAFF OF DANCEABILITY MAY REFUSE CLASSES TO ANY DANCER WHO'S TUITION IS DELINQUENT.
       
IFOR DANCEABILITY TO POST PICTURES OF THE ABOVE DANCER TO THEIR WEBSITE.
 
I understand and agree that in participating in an dance class, workshop, rehearsal or performance, there is a possibility of physical       injury. I voluntarily agree, therefore, to assume all risks and responsibility for such injury or accident, which might occur to my child or me during any of Danceability’s classes, rehearsals, performances or activities. I also exempt, release and indemnify Danceability, its owners, volunteers, assistants, employees, guests, faculty and/or students from any liability claims, demands or causes of action whatsoever from any damage, loss, injury to me or my children or property which may arise with participation in any classes or activities conducted by Danceability. I understand that I should be aware of my physical limitations and agree not the exceed them. If I am signing this waiver for my child, I certify that I am the parent of legal guardian and have the right to waive these rights.

I have read, understood and agree to be bound by the above statement. (Name)