The Dance Shoppe Online Registration

Registration

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Welcome to The Dance Shoppe! Milton's Family Dance Studio! 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*

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

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=dd/mm/yyyy)

Additional Info

T-Shirt Size

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Release

In part consideration of permitting my child (self) to participate in the activities of The Dance Shoppe Ltd., I agree to insure my child (self) against any injury or loss resulting from the activities and of travelling to and from theses activities. I agree to indemnify and save harmless The Dance Shoppe Ltd. and its employees, agents and volunteers from all losses, damages, claims and demands occasioned thereby. I authorize The Dance Shoppe Ltd. and its employees, agents and volunteers to provide all medical care, which they deem necessary for my child (self) in the event of injury. In Accordance with Ontario's Freedom of Privacy and Information Act, I hereby grant The Dance Shoppe Ltd. permission to videotape my child at the year-end recital and participate in the studio photographs which may be used for promotional purposes. The Dance Shoppe Ltd. will not be responsible for any theft, damage, or injuries during classes or on the location premises.

I've read the above and agree.

Cancellations

Cancelling within 30 days of registration or within your first 30 days of classes: Within 30 days after your registration date and or first 30 days of classes, a refund of the tuition balance only will be made or future payments will be suspended. Your cancellation request must be received in writing (email) within 30 days of your first class.

Cancelling after your first 30 days of classes: A cancellation fee of $40 will be charged and the remaining balance will be refunded or payments suspended.

Cancelling by TDS: Should the need arise for the studio to ask a parent to withdraw a dancer; a refund of the tuition balance only will be made and or the monthly installments discontinued.

Birthday Parties: No refunds.

I've read the above and agree.

Payments

You understand and agree that your payment(s) will be processed using the payment information you have provided to us. The Dance Shoppe will be taking the scheduled payments from the account or credit card provided to us. Monthly payments will be taken initially at the time of registration then continue on the 1st of each subsequent month up to and including June 1st, 2020. Annual payments will taken at the time of registration or shortly thereafter. Any rejected or declined payments will be processed again at a later date.

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*

Please fill out ONE of the following Payment Methods

Credit Card

Card Number

Exp Month

Exp Year

Card Nickname

Name as it appears on card

Address Line 1

Address Line 2

Country

City

State

Zip

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