The Studio School of Dance Online Registration

Registration

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THIS IS CARLETON PLACE LOCATION ONLY 13% H.S.T. added to fee. + Registration Fee of $30.00/dancer Require a PAYMENT PLAN?: complete the registration form ,fill out your request in the comment box below. Please be advised there is a $45 admin fee for payment plans. All registration comes directly to the office, is reviewed before fees are charged. Some classes have a Virtual option, please indicate Virtual on the 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/Prov*

Postal Code*

Primary Phone*

Additional Info

Emergency Contact Info

Contact #1

Contact #1 First Name*

Last Name *

Type*

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*

Preferred Pronoun*

Birth Date*

Cell #

Additional Info

Student Email

PLEASE LIST MEDICAL ISSUES

Dance Experience*

Recital Y/N

Classes and camps are filled on a first come basis. A waiting list will be available for any FULL class. If a class is marked FULL, please contact the office @ 613-253-2533 (CP) or complete the WAIT LIST information. Class registration is not considered confirmed until payment or payment plan has been received.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Preferred Pronoun*

Birth Date*

Cell #

Additional Info

Student Email

PLEASE LIST MEDICAL ISSUES

Dance Experience*

Recital Y/N

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Preferred Pronoun*

Birth Date*

Cell #

Additional Info

Student Email

PLEASE LIST MEDICAL ISSUES

Dance Experience*

Recital Y/N

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Preferred Pronoun*

Birth Date*

Cell #

Additional Info

Student Email

PLEASE LIST MEDICAL ISSUES

Dance Experience*

Recital Y/N

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Preferred Pronoun*

Birth Date*

Cell #

Additional Info

Student Email

PLEASE LIST MEDICAL ISSUES

Dance Experience*

Recital Y/N

Enroll in Classes

Select Class *

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Account Information

Payment Type e-transfer or c.c.

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/Prov

Postal Code

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

Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Account Information

Credit Card

eCheck/Bank Draft

Required Policies

(Show-Hide Details)