Toronto Dance: Summer 2004 Registration Form

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:

___________________________________

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. and Mambo Tribe. The e-mail address will only be used for dance-related information (e.g., class information, parties/outings/events).

Cost:

$75/p for 6 hours over 6 weeks ($12.50/h).
$18/person/h for a drop-in/try-out class.
Check with us for further discounts when you register for two or more different Toronto Dance classes (for new students only).

Classes:	*D.L.M. Studio*, 1610 Bloor St. W. (Bloor & Dundas)
	ü	TUESDAYS, May 25 to Jun 29, 2004 (1 hour/class for 6 weeks).
		Salsa Beginner 1	$ _____ 7:30 - 8:30pm
		Salsa Beginner 2	$ _____ 8:30 - 9:30pm
	ü	TUESDAYS, Jul 13 to Aug 17, 2004 (1 hour/class for 6 weeks).
		Salsa Beginner 1	$ _____ 7:30 - 8:30pm
		Salsa Beginner 2	$ _____ 8:30 - 9:30pm
	ü	TUESDAYS, Jul 20 to Aug 24, 2004 (1 hour/class for 6 weeks).
		Salsa Beginner 1	$ _____ 8:30 - 9:30pm

By signing this form,
I understand that Toronto Dance Inc., Mambo Tribe 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 Mambo Tribe. I have read and understood the above "Privacy Information" section. I allow pictures to be taken for promotional reasons.

Signature: _____________________________________ , ___________ 2004 (date)

Pay by cash or cheque (payable to “Mambo Tribe”). Send (do not fax) 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