REGISTRATION FORM                
   
Student's Name:   Age:
Birthday:      
Address:      
City:   Postal Code:
Phone:      
         
 
Mother/Guardian's Name:      
Phone:   Work/Cell:
Email: Required for Response      
         
 
Father/Guardian's Name:      
Phone:   Work/Cell:
Email:      
         
 
Are there any special medical conditions/injuries your instructor should be aware of? or have a Question?
         
 
Emergency Contacts      
Name(s) Phone #(s)      
     
     
     
 
 
ENROLLMENT FOR ELITE DANCE ACADEMY
REFERENCE: Forest Schedule  |  Sarnia Schedule
  
List Classes/Programs Day Time

         
         
Payment Option #1 (full payment with one cheque)
Payment Option #2 (3 post-dated cheques) NOT AVAILABLE FOR 8, 10 OR 12 WEEK SESSIONS
Payment Paypal Option #3 (Paypal Invoice) For more information please see note on Purchase online.
   

»

 VIEW POLICY STATEMENT
I have read, agree and understand Elite Dance Academy's Studio Policy Statement
         

Web Form Code

Enter Security Code as shown in box below
before proceeding to next step