| Name: | ______________________ | ____________________ |
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Registration Form 2005 |
| first name | last 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: |
$99/p for 9 hours over 9 weeks ($11/h) for new students.
$90/p ($10/h) for past Toronto Dance students. $63 when repeating. +$9/p extra for Latin-Ballroom level 2&3. Check with us for further discounts when you register for two or more different Toronto Dance classes (for new students only). |
| Classes: | Eastminster United Church, 310 Danforth Ave. (Danforth & Chester area) | |||
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MONDAYS, Mar 21 - May 30 (9 hours/11 weeks) No classes on Mar 28 (Easter Monday) No classes on May 23 (Victoria Day) |
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Latin-Ballroom level 1 | $ _____ 7:00 - 8:00pm | ||
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Latin-Ballroom level 3 | $ _____ 8:00 - 9:30pm (practice 9:00-9:30) +$9/p extra | ||
| ü | MONDAYS, Apr 4 - Jun 6 (9 hours/10 weeks) No classes on May 23 (Victoria Day) | |||
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Salsa-Nightclub level 1 | $ _____ 7:00 - 8:00pm | ||
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Salsa Nightclub level 2 | $ _____ 8:00 - 9:00pm | ||
| ü | WEDNESDAYS, Mar 23 - May 25 (9 hours/10 weeks) No classes on Mar 30 (room not available) | |||
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Latin-Ballroom level 2 | $ _____ 7:00 - 8:30pm (practice 8:00-8:30) +$9/p extra | ||
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Latin-Ballroom level 1 | $ _____ 8:30 - 9:30pm | ||
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: _____________________________________ , ___________ 2005 (date)
Pay by cash or cheque (payable to “Toronto Dance”).
Send (do not fax) reg form and cheque to:
Toronto Dance, Suite 3107, 38 Elm St., Toronto, ON. M5G 2K5