Dancers Name *

First Name

Last Name

Dancer's Gender: *

Male

Female

Parent/ Guardian Name *

First Name

Last Name

Cell Number *

(###)

###

####

Home Number

(###)

###

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I would like to register for the following classes: *

CD = $50 Costume deposit required for Year End Performance.

3/4 years Tuesday 4:00 - 4:30 (FULL - WAITLIST)

3/4 years Tuesday 4:45 - 5:15

I have read and understand the terms & conditions at the top of the form and agree to SGDA's policies. *

Agree

Auto-Pay - I understand and agree to the auto-pay policies *

Credit Cards/ Auto-Pay: Customers are to enrol in auto-pay where your credit card details are required. Sign up for auto-pay is completed upon registration. Auto-pay (charge to your credit card) will only be applied if payments for tuition or any other balances are 5 days overdue. Credit card payments automatically incur a 3.5% convenience fee per transaction. A customers credit card will not be charged if payment is received by an alternative method of payment (e-transfer/ cheque/ cash) on time.

Agree

I agree for my dancer's photo to be taken and allow SGDA to use the images for advertising purposes on posters/brochures/ websites/ social media/ studio notice board. *

Yes

No

Participation Waiver *

We require that the dancers PARENT/ GUARDIAN/ reads and agrees to the following waiver: The MEMBER/ PARENT/ GUARDIAN waives and releases Studio G Dance Academy; any program; and it’s employees from any and all claims for personal injury arising during the participation in any program, and/ or while waiting unsupervised before and after class. The MEMBER/ PARENT/ GUARDIAN has read the website/ brochure/ registration details and accepts all policies posted on studiogdanceacademy.com.

Agree

COVID-19 Waiver *

The MEMBER/ PARENT/ GUARDIAN waives and releases Studio G Dance Academy Ltd; any program; and it’s employees from any and all claims for the risk of being exposed to and/ or contracting COVID-19 while participating in any program, and/ or while waiting unsupervised before and after class and/ or entering the studio premises. The MEMBER/ PARENT/ GUARDIAN has read the website/ brochure/ registration details and accepts all policies. By checking the box the dancers PARENT/ GUARDIAN/ reads and agrees to the COVID-19 waiver. See waiver release form attached at the bottom of the registration form.

Agree

Chosen Payment Plan Option *

Fees can be divided into 8 payments for your convenience.

1 Payment - Pay in full Sept

8 Payments - Sept/ Oct/ Nov/ Dec/ Jan/ Feb/ Mar/ Apr