Toronto Dance Vibe

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Student Last Name:		Student First Name:
Birth Date (YYYY-MM-DD):		Age:
Address:		City:
Postal Code:

Mother / Guardian Name:		Mother Home Phone (XXX) XXX-XXXX:
Mother Work Phone (XXX) XXX-XXXX:		Mother Cell Phone (XXX) XXX-XXXX:
Mother Email Address:

Father / Guardian Name:		Father Home Phone (XXX) XXX-XXXX:
Father Work Phone (XXX) XXX-XXXX:		Father Cell Phone (XXX) XXX-XXXX:
Father Email Address:

If parent/guardian is unable to be reached, please contact:
Emergency Contact:		Phone:

Class 1:
Class 2:
Class 3:
Class 4:
Class 5:
Class 6:
Class 7:
Class 8:
Class 9:
Class 10:

New Student:	Returning Student:	Years of Training:
Please indicate any physical or learning conditions that the instructor should be aware of. ( Example: Asthma, etc. )


Referred by:

I agree to uphold any and all policies established by the studio and Toronto Dance Vibe. I agree to release any and all rights and claims against Toronto Dance Vibe and all it’s staff and instructors of any claims for injuries that may occur to the student, parent or any other person. I understand that the studio is not responsible for any personal belongings not owned by the studio, I understand that all tuition and fees paid are non-refundable once deposited, ALL POST-DATED cheques are REQUIRED at registration, NO EXCEPTIONS. I give permission for Toronto Dance Vibe to use any photos, videos and names of the above student(s) for educational and promotional purposes. I have read and agree to the above terms.
Please type your name as your electronic signature:		Date (YYYY-MM-DD):
Parents are asked to keep themselves informed of studio events by reading the signs posted on the studio door and on the bulletin board. Information is also available on our website at www.dancevibes.com. Please remain informed of studio events to avoid disappointment.