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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 | Flyer | Referral | Business card |
Privacy Information: The above information is kept confidential by Toronto Dance Inc. and Dance With Alana. The e-mail address will only be used for dance-related information (e.g., class information, parties/outings/events).
| Cost: |
Prices / person are listed below with each class $112/person for any 8 classes/hours. $15/person/h for a drop-in/try-out class. |
| Classes: | Mad for Dance Studio, 263 Adelaide St West, Suite B-10 or B-30 (basement) (at John St) | ||
| ü | MONDAYS, Jan 10 to Apr 25, 2005 (1 hour/class for 15 weeks) No classes on Mar 28 (Easter) | ||
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Tap Beginner 2 | $ _____ 5:30 - 6:30pm (Studio B-30) $180/p | |
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Tap Intermediate 1 | $ _____ 6:30 - 7:30pm (Studio B-30) $180/p | |
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Tap Intermediate 2 | $ _____ 7:30 - 8:30pm (Studio B-30) $180/p | |
| ü | WEDNESDAYS, Jan 12 to Apr 27, 2005 (1.25 hours/class for 16 weeks) | ||
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Lindy Hop Beginner 1 | $ _____ 6:00 - 7:15pm (Studio B-30) $192/p | |
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Lindy Hop Beginner 2 | $ _____ 7:15 - 8:30pm (Studio B-30) $192/p | |
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Lindy Hop Intermediate 1 | $ _____ 6:00 - 7:15pm (Studio B-10) $192/p | |
| ü | THURSDAYS, Jan 13 to Apr 28, 2005 (1 hour/class for 16 weeks) | ||
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Tap Beginner 1 | $ _____ 5:30 - 6:30pm (Studio B-30) $192/p | |
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Jazz/Hip Hop Beginner 1 | $ _____ 6:30 - 7:30pm (Studio B-30) $192/p | |
By signing this form,
I understand that Toronto Dance Inc., Dance With Alana 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 Dance With Alana. 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 “Alana Hock”).
Send (do not fax) registration form and cheque to:
Toronto Dance, Suite 3107, 38 Elm St., Toronto, ON. M5G 2K5