Traditions Academy of Dance 307 Brock Street NorthWhitby ON L1N 4H8 (905) 666-1528 www.traditionsdance.ca email@example.com ONLINE REGISTRATION FORM (One form per student) online-registration (1) Student’s Name:* First Last Account/Parent’s Name:* First Last Address* Street Address Unit Number City ZIP / Postal Code Phone:Res:*Work:Cell:*Email* Student’s Cell Phone:Student’s E-mail: (optional) Alternate Contact Info:Student’s Date of Birth: (yy/mm/dd)* Date Format: MM slash DD slash YYYY Age as of Dec 31:*Medical Info:Dance Program: *(Minimum of 1 selection required)Full-Time Program: 5.5 - 8.5 Hours per week 9 Hours & up per week Syllabus Classes: R.A.D. Ballet (5 yrs & up) Pointe R.A.D. Pre-School (2.5-4 yrs) I.S.T.D. Modern (4 yrs & up) I.S.T.D. Tap (5 yrs & up) I.S.T.D. Jazz Recreational Classes: Hip Hop (5 yrs & up) Jazz (5 yrs & up) Lyrical Acro Musical Theatre Teen Ballet Competition Classes: Tadpoles Angels In-Ta Kids: Level 1 2 3 4 Triple H : Level 1 2 Gingersnaps Technique Classes Skills & Drills Please contact me because I am unsure of which class(es) to select.Waiver: On behalf of myself and all of my heirs, successors, I hereby release, save, & hold harmless the owners/operators of the dance studio located at 307 Brock Street North, Whitby, Ontario, its founders, successors, agents, and assigns from any and all claims, causes of actions, suits of liability, costs and expenses arising out of, or in connection with any loss, personal injury, illness, death, or other damage including consequential damages that I may incur or suffer by reason of or as a result of my participation in any program conducted on the premises located at the above address and at off-premises, studio functions including recitals, competitions, workshops, demonstrations and promotions etc.* Yes, I have read, understand and agree.Date Date Format: MM slash DD slash YYYY Note: Payment options are arranged at the Studio with Administrative Staff. Visit our website to see important notices, dates and events.