Canadian Dance Company - Burlington Online Registration

Registration

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WELCOME, to Canadian Dance Company - Burlington, in order to register, please fill out all required fields of the registration form including payment information to enrol in selected Classes to complete the enrolment process. Once your registration has been approved and payment has been processed you will receive a confirmation email that you are registered for your selected classes providing there are spaces available.

* 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*

State*

Zip*

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

Student #1

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

School

Grade Level

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

School

Grade Level

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

School

Grade Level

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

School

Grade Level

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

School

Grade Level

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Online Registration Payment

By registering online, I agree that the credit card information provided will be automatically charged for registration of the classes, programs or camps that I have selected. Acceptable methods of payment: Automatic Payment - Visa, MasterCard, American Express.

Summer classes/programs/camps: will be charged upon registration with no annual membership fee.
Full year programs: annual membership fee ($30 + HST) and first months tuition fee's will be charged upon registration, the remainder months will be charged full month tuition on the 27th day of the previous month (ie. September 27th re: October tuition), (Note: Tots Dance 2 & All By Myself programs are a 12 week session program, full payment of session is due upon registration). Season runs September through June. There are absolutely NO refunds or transferals on any fees that have been paid to the Canadian Dance Company. Thank you for your registration, and we look forward to having you a part of Canadian Dance Company.

Canadian Dance Company Fitness (Zumba) is exempt from Annual Membership Fees.