Dance Dynamics Studio Online Registration

Registration

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Welcome to Dance Dynamics Studio -936 Tungsten Street, Thunder Bay - Please note TIMES are subject to change based on enrollment and COVID-19 restrictions

* denotes required fields

Referral Information

How did you hear about us?*

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State/Prov*

Postal Code*

Home or Primary Phone*

Additional Info

Emergency Contact Info
(Not Contact #1 or #2)

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type*

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email

School

Disabilities*

Special Needs*

Allergies*

Primary Doctor

OHIP#*

Please contact us at trevor@tbaytel.net if you have any questions or difficulty registering You cannot make your payment directly here, only through your authorization upon receipt of your invoice will we process payment to your credit card if you have entered it.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email

School

Disabilities*

Special Needs*

Allergies*

Primary Doctor

OHIP#*

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email

School

Disabilities*

Special Needs*

Allergies*

Primary Doctor

OHIP#*

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email

School

Disabilities*

Special Needs*

Allergies*

Primary Doctor

OHIP#*

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email

School

Disabilities*

Special Needs*

Allergies*

Primary Doctor

OHIP#*

Enroll in Classes

Select Class

Add Another Student