Registration Form Form

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Enrichment-Competitive stream registration form

Student's Name *

Parent's Name *

* Indicates required field

Birth Year *

Gender *

Birth Month *

Birth Day *

Age as of Dec 31st, 2020 *

Address *

Home Phone *

Emergency Contact *

City *

Cell Phone *

Emergency Contact Phone Number *

Postal Code *

Cell Phone *

Email *

How did you hear about Pointflex? *

Name of Referral *

Healthcare concerns we should be aware of *

Comments *

I am a... *

New Student Returning Student

Years Experience (begin counting from age 6) *

Name of Previous Dance Studio *

Pre Junior Pre Competitive 7-9 Years *

Primary Ballet Pre Junior Tap/Jazz Combo Acrobatics Hip Hop

Junior 1 8-11 Years *

Grade 1 Ballet 2x classes per week Junior 1 Tap Junior 1 Jazz Acrobatics Hip Hop Musical Theater

Junior 2 8+ Years *

Grade 1 Ballet 2x classes per week Junior 2 Tap 1x class per week Junior 2 Jazz 2x classes per week Acrobatics Hip Hop Musical Theatre

Junior 3, 9+ Years *

Grade 1 or 2 Ballet 2x classes per week Junior 3 Tap 2x classes per week Junior 3 Jazz 2x classes per week Acrobatics Lyrical/Contemporary Hip Hop Musical Theater

Pre Intermediate 1-3 *

Ballet 2x classes per week Tap 2x classes per week Jazz 2x classes per week Acrobatics Lyrical/Contemporary Hip Hop Musical Theater

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Contact us today about booking your trial lesson!

Telephone

306-540-4150

Email

admin@pointflexdancecompany.com