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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 Swing and Tap Academy. 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.
| Cost: |
$85/person for 6 classes (7.5 hours) by Jan 6 $95/person for 6 classes (7.5 hours) Jan 7 onward |
| Classes: | Mad for Dance Studio, 263 Adelaide St West, Suite B-10 or B-30 (basement) (at John St) | ||
| ü | WEDNESDAYS, Jan 13 to Feb 17, 2009 (1.25 hours/class for 6 weeks) | ||
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Swing/Lindy Hop Beginner 1 | $ _____ 7:00 - 8:15pm (Studio B-10) | |
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Swing/Lindy Hop Performance | $ _____ 7:00 - 8:15pm (Studio B-30) ($100 for 8 weeks) | |
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Swing/Lindy Hop Level 3 | $ _____ 8:15 - 9:30pm (Studio B-10) | |
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Swing/Lindy Hop Level 2a | $ _____ 8:15 - 9:30pm (Studio B-30) | |
By signing this form,
I understand that Toronto Dance Inc., Swing and Tap Academy 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 or Swing and Tap Academy. 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 “Swing and Tap Academy of Toronto”).
Send (do not fax) registration form and cheque to:
Chuan Chee, Toronto Dance Inc., 38 Elm St., Suite 3107, Toronto, ON. M5G 2K5