| Name: | ______________________ | ____________________ |
|
Registration Form 2005 |
| first name | last name |
| Phone: | _________________ , | __________________ , | ________________ |
| home | business | cell |
| E-Mail: | ___________________________________ |  Male or
Female |
| Address: | _________________________ , | _____ , | _____________ , | _________ |
| street | apt/suite | city | postal code |
| How did you find us (if new student)? (circle one) | Web search | Flyer | Referral | Business card |
Privacy Information: The above information is kept confidential by Toronto Dance Inc. The e-mail address will only be used for dance-related information (e.g., class information, Toronto Dance parties/outings/events).
| Cost: |
$99/p for 9 hours over 9 weeks ($11/h) for new students.
$90/p ($10/h) for past Toronto Dance students. $63 when repeating. Northridge Club members get an additional $1/h discount. Check with us for further discounts when you register for two or more different Toronto Dance classes (for new students only). |
| Classes: |
Northridge Club, North American Centre, 5650 Yonge St. (Yonge and Finch, at Finch subway station) |
||
| ü | WEDNESDAYS, Jan 12 - Mar 9 (9 hours/9 weeks) | ||
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Latin-Ballroom level 1 | $ _____ 7:30 - 8:30pm | |
|
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Salsa-Nightclub level 1 | $ _____ 8:30 - 9:30pm | |
| ü | THURSDAYS, Jan 13 - Mar 10 (9 hours/9 weeks) | ||
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Salsa-Nightclub level 3 | $ _____ 7:30 - 8:30pm | |
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Salsa-Nightclub level 2 | $ _____ 8:30 - 9:30pm | |
By signing this form,
I understand that Toronto Dance Inc. or its employees/contractors/helpers are not held responsible for any loss or theft of articles on the premises and are not held liable for injury or health risk sustained in the dance classes or any dance outings organized by Toronto Dance. I have read and understood the above "Privacy Information" section. I allow pictures to be taken for promotional reasons.
Signature: _____________________________________ , ___________ 2005 (date)
Pay by cash or cheque (payable to “Toronto Dance”).
Send (do not fax) reg form and cheque to:
Toronto Dance, Suite 3107, 38 Elm St., Toronto, ON. M5G 2K5