- Confederation Centre of the Arts

Dance Program Registration Form 2025-2026

Student Name

Full Name

Parents/ Guardians

Full name

Address

Street Address City Postal Code

(for class notices, etc. – please use one you check frequently)

Primary Phone

Secondary Phone

Student's Age

Student Preferred Pronouns

She/Her

He/Him

They/Them

Prefer Not To Say

Other

Student Is New To Dance Program

Returning From Previous/Other Years

IF NEW TO dance umbrella, HOW DID YOU HEAR ABOUT THE PROGRAM?

PLEASE DESCRIBE any needs you/your child may have, including behavioral support, medical conditions, allergies, physical limitations etc

PLEASE INDICATE WHICH CLASS(ES) YOU ARE REGISTERING FOR (please include name of class, day, and time)

Class

Day

Time

Class

Day

Time

Class

Day

Time

I HEREBY GIVE CONSENT AND REGISTER above mentioned student in dance class(es) conducted by Confederation Centre’s dance umbrella, and understand and accept the terms and conditions which apply. I have also read and understand the sheet of “Important Information”. PLEASE BE ADVISED that all classes may be documented by photos and video. Photographs may be used for marketing and publicity purposes. PRIVACY STATEMENT Confederation Centre of the Arts is the sole owner of the information collected here and through our website. We will not sell or otherwise distribute this information to third parties.

I CONSENT TO PHOTOS OF MY CHILD

I DO NOT CONSENT TO PHOTOS OF MY CHILD

KEEP ME UP TO DATE ON PROMOTIONS AND NEW EVENTS AT AND AROUND CONFEDERATION CENTRE OF THE ARTS

Signature

Date

Credit Card Number

Name On The Card

Exp Date

CVV