Dance Registration Form

ADVERTISEMENT

A.B. Dance Registration Form
 
Student Name_________________________________________
This is my _____ year at AB Dance.
Gender ________
Birth Date __________/________/_________
Age __________
Day
Month
Year
Telephone #______________________________________
Address___________________________________________________________________
City__________________________________ Postal Code________________________
Parent/Guardian Name_________________________Cell #_____________________
Parent /Guardian Name__________________________Cell#____________________
Email Address___________________________________________________
Medical Information (describe all allergies, injuries, and medical
conditions)________________________________________________________________
____________________________________________________________________________
Parent/ Guardian Signature_______________________________________________
Date____________________________
I agree to the registration information, policies and the principles of A.B. Dance Inc. I release A.B. Dance Inc.,
Andrea and Ashley Barnes, all teachers, staff, employees and assistants from any and all liability actions, negligence
or lawsuits arising from any activity while in the studio, while using studio facilities or in studio vicinity and /or in
relation to any travels conducted by A.B. Dance Inc., including dance competitions attended by A.B. Dance Inc.. I
hereby allow A.B. Dance Inc. to use photos of myself and/or my children for promotional use at any time.
Please complete the chart below. Refer to the 2015-2016 class schedule.
Class
Teacher
Day
Time
Thank You for choosing A.B. Dance!!
*First Term, Second Term and Costume cheques are due at registration to secure classes *
Please make all cheques payable to A.B. Dance Inc.
--------------------------------------------------------------------------------------------------------------
First term – Dated: Date of Registration: $______________
chq # _________
Second Term Dated Jan. 1
2016:
$_______________ chq #__________
st
Rec Costume Cheque Dated Nov. 1
2015: $_____________
chq # __________
st
*There will be a $25.00 charge for late costume orders*
*
: $__________ chq # _______
Dated Oct 1
2015
COMP Costume Deposit ($100 per costume)
st
___________ We will not be participating in the year end recital (please initial)
New students: How did you hear about A.B. Dance?
___ Newspaper ___Town of Markham Magazine ___ Friend ___ Internet

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Life
Go