Edgett Dance - Register

Program Registration Form

- Receive $10.00 off of your registration fee if you register for our Introductory Plus classes by February 29.

- Elements marked by a '*' are required fields, and must be filled in to continue.

- Note that if you are interested in the Competitive Program, we request that you visit us at the studio, where we will sit down with you to discuss where in our program you best fit. This will also give our instructors an opportunity to test your dance skills and gain a better idea of where you fit within the program structure. If this is your intention, please either register with us in the studio, or indicate your previous training in the "Additional Information" box found at the end of the form, and we will discuss a time when it would be suitable for you to come to the studio for testing.

- Note that it is not necessary for you to have a partner, as we have a number of individuals who donate their time to ensure that there is a partner for everyone.

Title:
Full Name: *
	e.g. John Doe
Street: *
	e.g. 000 This Address Street
City: *
	e.g. Namedcity
Postal Code: *
	e.g. A0A 0A0
E-mail Address: *
	e.g. yourname@yourhost.com
Home Phone Number: *
Work Phone Number:
Other Phone Number:
	e.g. 555-5555
Date of Birth: *
	e.g. 01/01/1990 (dd/mm/yyyy)

Additional Information:
Method of Payment: *
Please check here if you wish to receive confirmation of your registration:
By checking this box you are agreeing to Edgett Dance Center's policies (.pdf): *