| Name: | ______________________ , | ____________________ |
|
Registration Form 2004 |
| 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. The e-mail address will only be used for dance-related information (e.g., class information, Toronto Dance parties/outings/events).
| Cost: | $77/p for 7 hours over 7 weeks ($11/h). |
| Classes: | The Adelaide Club, First Canadian Place (Bay & Adelaide area) | |||
| ü | SUNDAYS and TUESDAYS | Please see another registration form | ||
| Classes: | Eastminster United Church, 310 Danforth Ave. (Danforth & Chester area) | |||
| ü | MONDAYS, Feb 2 - Mar 15 (7 hours/7 weeks) | |||
|
|
Salsa-Nightclub Beginner 1 | $ _____ 8:00 - 9:00pm | ||
| Classes: | Calvin Presbyterian Church, 26 Delisle Ave. (Yonge and St.Clair area) | |||
| ü | WEDNESDAYS, Jan 28 - Mar 10 (7 hours/7 weeks) | |||
|
|
Salsa-Nightclub Beginner 1 | $ _____ 9:00 - 10:00pm | ||
| Classes: |
Life Sport Fitness Centre, Empress Walk Mall, 5095 Yonge St., Unit C2 (Yonge, between Sheppard and Finch, at North York Centre subway station) |
|||
| ü | THURSDAYS, Jan 29 - Mar 11 (7 hours/7 weeks) | |||
|
|
Salsa-Nightclub Beginner 1 | $ _____ 9:30 - 10:30pm | ||
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: _____________________________________ , ___________ (date)
Pay by cash or cheque (payable to “Toronto Dance”).
Send registration form and cheque to:
Toronto Dance, Suite 3107, 38 Elm St., Toronto, ON. M5G 2K5