Body Stories Dance Education & Performance Online Registration

Registration

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Welcome to Body Stories Dance Instruction! This registration form is for Kagawong and Little Current classes ONLY. Manitowaning registration is done through the Assiginack website: www.assiginack.ca If you are already a registered client, please use the link above to access your family portal. Haven't danced with us in a while? Email bodystoriesdance@gmail.com to reactivate your account.

* 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*

Province*

Postal Code*

Primary Phone*

Additional Info

Join our email list? (Y or N)*

Contact #1

Primary Contact First Name*

Last Name *

Relationship to Dancer*

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

Secondary Contact First Name

Last Name

Relationship to Dancer

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Gender

Birth Date*

Additional Info

Medical Information or Health Concerns

Student's Pronouns

Past Dance Experience*

Please click on the button below, then choose the class. Use the search button in the top left corner to filter class options.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Gender

Birth Date*

Additional Info

Medical Information or Health Concerns

Student's Pronouns

Past Dance Experience*

Please click on the button below, then choose the class. Use the search button in the top left corner to filter class options.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Gender

Birth Date*

Additional Info

Medical Information or Health Concerns

Student's Pronouns

Past Dance Experience*

Please click on the button below, then choose the class. Use the search button in the top left corner to filter class options.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Gender

Birth Date*

Additional Info

Medical Information or Health Concerns

Student's Pronouns

Past Dance Experience*

Please click on the button below, then choose the class. Use the search button in the top left corner to filter class options.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Gender

Birth Date*

Additional Info

Medical Information or Health Concerns

Student's Pronouns

Past Dance Experience*

Please click on the button below, then choose the class. Use the search button in the top left corner to filter class options.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

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

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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

Credit Card

Required Policies

(Show-Hide Details)