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On-line Registration

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Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Health Card #

# Of dancers to register(Required)

1st Dancers Name(Required)

First Last

1st Dancers Birthday(Required)

MM slash DD slash YYYY

2nd Dancers program you want to register for(Required)

Lyrical

Preschool

Kinder

Advanced Kinder

Jazz

Tap

Ballet

Acro

Hip Hop

Pointe

Adult Dance

1st Dancers preferred program time

Hours

:

Minutes

AM/PM

1st Dancers medical information

2nd Dancers Name(Required)

First Last

2nd Dancers Birthday(Required)

MM slash DD slash YYYY

2nd Dancers program you want to register for(Required)

Lyrical

Preschool

Kinder

Advanced Kinder

Jazz

Tap

Ballet

Acro

Hip Hop

Pointe

Adult Dance

2nd Dancers preferred program time

Hours

:

Minutes

AM/PM

2nd Dancers medical information

3rd Dancers Name(Required)

First Last

3rd Dancers birthday(Required)

MM slash DD slash YYYY

3rd Dancers program you want to register for(Required)

Lyrical

Preschool

Kinder

Advanced Kinder

Jazz

Tap

Ballet

Acro

Hip Hop

Pointe

Adult Dance

3rd Dancers preferred program time

Hours

:

Minutes

AM/PM

3rd Dancers medical information

Contact Information

Dimensions In Dance
1382-B Weber St. E.
Kitchener, ON N2A 1C4

Phone: 519.896.0931
Email: office@dimensionsindance.ca

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Summer 2023
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