Sing Like A STAR Online Registration

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Referral Information

How did you hear about us?*

Family Information

Last Name of Student Last Name*

Where do you live?

Home Address*

City*

Province*

Postal Code*

Primary Phone*

Additional Info

Emergency Contact Info (Provide a name & phone # which is different than Contact #1 or #2 below)

Contact #1

Contact #1 First Name*

Last Name *

Relationship to Student*

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*

Additional Info

School*

Grade Level*

Does the above student have any diverse needs that we may be able to assist in accommodating?

Are there any allergies or medical conditions we need to be away of?

Medications we need to know about

Is student NEW or RETURNING?*

If NEW, did someone refer you?

If YES, what child or parent?

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Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

School*

Grade Level*

Does the above student have any diverse needs that we may be able to assist in accommodating?

Are there any allergies or medical conditions we need to be away of?

Medications we need to know about

Is student NEW or RETURNING?*

If NEW, did someone refer you?

If YES, what child or parent?

Discount CODE:

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

School*

Grade Level*

Does the above student have any diverse needs that we may be able to assist in accommodating?

Are there any allergies or medical conditions we need to be away of?

Medications we need to know about

Is student NEW or RETURNING?*

If NEW, did someone refer you?

If YES, what child or parent?

Discount CODE:

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

School*

Grade Level*

Does the above student have any diverse needs that we may be able to assist in accommodating?

Are there any allergies or medical conditions we need to be away of?

Medications we need to know about

Is student NEW or RETURNING?*

If NEW, did someone refer you?

If YES, what child or parent?

Discount CODE:

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

School*

Grade Level*

Does the above student have any diverse needs that we may be able to assist in accommodating?

Are there any allergies or medical conditions we need to be away of?

Medications we need to know about

Is student NEW or RETURNING?*

If NEW, did someone refer you?

If YES, what child or parent?

Discount CODE:

Enroll in Classes

Select Class

Add Another Student

Required Policies

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Questions or Concerns

Comments

Payment Information

Account Information

Would you prefer to pay by Credit Card or eTransfer?*

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

Country *

City

Province*

Postal Code*

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

Required Policies

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