Street Address

City, State, Zip

Phone Number

Your Custom Text Here

Kindly fill in and submit the Registration Form below.
IMPORTANT: Due to the limited capacity of the classes (12 to 18 students max. per class), registrations will be accepted on a“first come –first serve” basis, with a priority given to returning students.

Student’s personal details :

Nom / Last Name

Prénom / First Name

Date of Birth

Nationality

Spoken Languages

Height

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Telephone Number

Mobile

School

Class

Bus#

Miscellaneous

Did you ever take dance classes before ?
What sort ?
How many years ?
Last year = ?
How did you learn about the dance classes ?

Avez-vous déjà fait de la danse ?
Si oui, quel type ?
Combien d'années ?
Dernière année = ?
Comment avez-vous connu ces cours de danse ?

Wishes to enroll to / Cours choisi(s)

Class 1

Class 2

Class 3