Toronto Dance: Fall 2003 Registration Form

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Toronto Dance ™ Registration Form
(Please print clearly when filling in the form)

In conjunction with

Name:	______________________ ,	____________________
	last name	first name

Phone:	_________________ ,	__________________ ,	________________
	home	business	cell

E-Mail:

___________________________________

Address:	_________________________ ,	_____ ,	_____________ ,	_________
	street	apt/suite	city	postal code

How did you find us? (circle one)

Web search

Flyer

Referral

Business card

_____________

Cost:

$85/person for 8 hours over 8 weeks ($10.63/h).
$15/person for trying out a 1-hour class (phone before attending).
Check with us for further discounts when you register for two or more Toronto Dance classes.

Classes:	*Studio 27*, 27a Bloor St East (south-east corner of Yonge & Bloor)
	ü	TUESDAYS, Sep 2 to Oct 21, 2003 (1 hour/class for 8 weeks).
		West-Coast Swing Beginner 1	$ _____ 7:30 - 8:30pm
		West-Coast Swing Beginner 2	$ _____ 8:45 - 9:45pm

By signing this form,
I understand that Toronto Dance ™ , Groovy Bluesy Jazzy Funky 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 allow pictures to be taken for promotional reasons.

Signature: _____________________________________ , ___________ (date)

Pay by cash or cheque (payable to “Julie Epplett”). Send registration form and cheque to:
Toronto Dance, Suite 3107, 38 Elm St., Toronto, ON. M5G 2K5

416-598-4077, torontodance@hotmail.com, www.torontodance.ca