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Toronto Dance ™ Registration Form (Please print clearly when filling in the form) |
In conjunction with ... |
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| 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 | Ad | Flyer | Referral | Business card |
Privacy Information: The above information is kept confidential by Toronto Dance Inc. and Gorete Almeida. The e-mail address will only be used for dance-related information (e.g., class information, parties/outings/events).
Policies: NO refunds, make-up classes or credits for missed lesson on full session registrations. You may pay for fewer classes if you know that you will be away or busy on certain weeks. No refunds for missed classes.
| Cost: |
$96/person by Oct 20 for 6 classes (6 hours) $112/person after Oct 20 If trying first class, $20/person/h for first class + $80/p for remainder. |
| Classes: | Eclipse Fitness Club, 2300 Yonge St, Yonge Eglinton Centre (NW corner Yonge & Eglinton, 2nd floor, next to Toys 'R Us) | ||
| ü | MONDAYS, Oct 25 to Nov 29, 2010 (1 hours/class for 6 weeks) | ||
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Cardio Salsa beginner | $ _____ 7:30 - 8:30pm | |
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Cardio Salsa intermediate | $ _____ 8:30 - 9:30pm | |
| ü | TUESDAYS, Oct 19 to Dec 7, 2010 (1 hour/class for 8 weeks) | ||
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Cardio Salsa advanced | $ _____ 7:30 - 8:30pm | |
By signing this form,
I understand that Toronto Dance Inc., Gorete Almeida 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. I have read and understood the above Privacy Information and Policies sections. I allow pictures to be taken for promotional reasons.
Signature: _____________________________________ , ___________ 2010 (date)
Pay by cash or cheque (payable to “Gorete Almeida”).
Send (do not fax) registration form and cheque to:
Gorete Almeida, Toronto Dance, 17 Fairfield Rd, Toronto, ON. M4P 1S9
or bring your form and payment to Eclipse Fitness Club if there
are classes going on (call to confirm).