First Name:
Last Name:
Street Address:
City:
Postal Code:
Home Phone:
Work Phone:
E-mail:
Date of Birth: (MMDDYY)
Age:
Are you a current client of the studio?
Yes No
If yes, how long have you been with the studio?
yrs
What is your current level of dance training?
Please select all classes that you wish to register for.
Ballet Ballet Exam Pre-Ballet Pointe Jazz
Jazz Exam Tap Tap Exam Hip-Hop Musical Theatre
Modern Solo/Duo/Trio Student Choreography Degas Dance Company
Would you like to be informed about upcoming dance auditions, workshops or professional dance shows?
LIABILITY WAIVER (Please check the appropriate box)
I hereby, for myself, my heirs, executors and administrator, waive and release any and all any rights and claims or damages I may have against ABBOTSFORD BALLET STUDIO, THE BALLET STUDIO or 462329 BRITISH COLUMBIA LTD. and its agents or representatives for any/all injuries suffered by me or any member of my family. (This waiver is to be signed by the student or his/her guardian if under 19 years of age.)
I agree.
I disagree.
