Registration
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FULL TIME COMPANY AUDITIONS (13 + YRS) June 30, 2022 7:45pm-8:45pm
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Parent/Guardian
*
Caregiver
Father
Guardian
Mother
Parent
Self
Home Phone:
*
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
City:
*
State/Prov:
*
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code:
*
Students entered below will be added to your family's account
Add New Student #1:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Questions/Options:
Indicate whether the student can complete an aerial.
*
Yes
No
Has the student danced competitively before? Indicate where they have danced previously and for how long in the 'Additional Information' box below.
*
Yes
No
Additional Information:
Release of Liability
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In the event of accident or injury, I agree to hold harmless Art & Soul Dance Company.
I've read the above and agree.
Release of Liability
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I agree and understand that my or my child's attendees at any event is considered consent to be photographed and recorded and that all images or self likeness may be used in promotional materials and print media.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
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