Steps Dance Centre Online Registration

Registration

Already a customer? Click here to login.

Welcome to Steps Dance Centre! Please complete the following registration form.

* denotes required fields

Referral Information

How did you hear about us?

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

Province*

Postal Code*

Home or Primary Phone*

Additional Info

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

Contact #1

Contact #1 First Name*

Last Name *

How Can We Contact You?

Home Phone

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

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)

Additional Info

Student Email

School

Special Needs

Allergies

Please click on the Search button below, then choose the class. Please note that all 2019 spring break or summer classes will be charged to the credit card on file at time of registration. If the class you want is full please join the wait list and we may attempt to add another class if there is enough interest.

Enroll in Classes

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

School

Special Needs

Allergies

Please click on the Search button below, then choose the class. Please note that all 2019 spring break or summer classes will be charged to the credit card on file at time of registration. If the class you want is full please join the wait list and we may attempt to add another class if there is enough interest.

Enroll in Classes

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

School

Special Needs

Allergies

Please click on the Search button below, then choose the class. Please note that all 2019 spring break or summer classes will be charged to the credit card on file at time of registration. If the class you want is full please join the wait list and we may attempt to add another class if there is enough interest.

Enroll in Classes

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

School

Special Needs

Allergies

Please click on the Search button below, then choose the class. Please note that all 2019 spring break or summer classes will be charged to the credit card on file at time of registration. If the class you want is full please join the wait list and we may attempt to add another class if there is enough interest.

Enroll in Classes

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

School

Special Needs

Allergies

Please click on the Search button below, then choose the class. Please note that all 2019 spring break or summer classes will be charged to the credit card on file at time of registration. If the class you want is full please join the wait list and we may attempt to add another class if there is enough interest.

Enroll in Classes

Add Another Student

Required Policies and Agreements

Registration Fee

I understand I will be charged a $25.00 registration fee that will be charged after registration and processed to the payment method on file. (This is only for regular season classes, Not Adult, summer classes or short term sessions.) This fee is reduced to $15.00 if registration was done during pre-registration or at the directors discretion.

I've read the above and agree.

Release Form

It is clearly understood and agreed that the undersigned, parent/guardian and his/her agents will indemnify Steps Dance Centre and its ownership (Jessica Allen), respective employees and contractors from all claims whatsoever including all
damages, liabilities, expenses and costs including legal or other fees incurred in respect of any such claim(s)
or proceedings arising directly or indirectly from the programs, instruction, the facility and equipment used.

I've read the above and agree.

Medical Attention

In case of physical injury or medical emergency, I hereby authorize Steps Dance Centre to make necessary arrangements to transport myself or my child to a medical treatment facility as necessary. All such transportation and medical treatment will be at my sole cost and expense. In extreme emergency, or if my child is under 18 years of age, I understand that Steps Dance Centre will attempt to notify the person(s) I have named below as my emergency contact(s) of my condition and how to reach me.

I've read the above and agree.

Photo/Video Release

I grant Steps Dance Centre, its representatives, employees and contractors the
right to take photographs/Videos of me and/or my child and my property in connection with
the Steps Dance Centre activities and subjects. I authorize Steps Dance Centre, its
assigns and transferees to copyright, use and publish the same in print
and/or electronically.
I agree that Steps Dance Centre may use such photographs of me
with or without my name and for any lawful purpose, including for
example such purposes as publicity, illustration, advertising, and Web
content. This includes posting to Steps Dance Studio webpage and Facebook page.

I've read the above and agree.

Protection of Property

I understand and agree that it is my sole responsibility to safeguard my personal property while attending or participating in any classes, rehearsals, workshops, or performances. I hereby release Steps Dance Centre, its ownership, its affiliate dance studios, event sponsors, employees and dance teachers from all liability for loss or damage to my personal property while attending or participating in classes, rehearsals, workshops, fitness classes or performances. I also agree to abide by any rules, regulations and policies set forth by Steps Dance Centre.

I've read the above and agree.

Payment

I understand that payment will be charged to my Credit card on file July 1 2019 or once registration is complete if registration is after July 1 2019 for summer camps. If No credit card on file then payment is due July 1 2019 and arrangements can be made by emailing stepsdancecentre@shaw.ca.

I've read the above and agree.

Acknowledgement of Waiver

In accepting this Release, I acknowledge and represent that I have fully informed myself of the content of the waiver and hold harmless agreement by reading it before I sign it, and I understand that I sign this document as my own free act and deed; no oral representations, statements, or inducements, apart from the written statement, have been made. I further state that I am at least eighteen (18) years of age and am fully competent to sign this agreement; and that I execute this release for full, adequate, and complete consideration fully intending to be bound by the same. I further state that there are no health-related reasons or problems which preclude or restrict my or my child's participation in this activity, and that I will pay any medical costs that may be attendant as a result of injury to me or my child.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Account Information

e-Payment Schedule*

Payment Option*

Credit Card

Card Number

Exp Month

Exp Year

Card Nickname

Name as it appears on card

Address Line 1

Address Line 2

City

Province

Postal Code

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Transit # (5-digits)

Institution ID (3-digits)

Account Number