MJPAS 2022-2023 RECREATIONAL DANCE REGISTRATION!

Miss Jennie's Performing Arts Studio Inc.

Thank you for choosing Miss Jennie's! We are looking forward to seeing you soon!

MJPAS is turning 15 and we can't wait to celebrate this milestone with you!

Classes will start September 10th. The entire first week will be a free trial week so we hope that we'll see you to give your preferred class(es) a try!

To get your dancer ready for their first…

Parent/Guardian Information

E-mail

First name

Last name

Phone

Participant's Information - Registration Form

Participant's Name

Participant's Birthdate (dd/mm/yyyy)

Participant's Address

Parent/Guardian's Phone Number

Alternate Emergency Contact's Name

Emergency Contact's Phone Number

Medical Information (illnesses, medications, hospitalizations, surgeries, etc.) (optional)

Allergies/Intolerances (For anaphylactic reactions, an additional form is required. Please inquire at the studio) (optional)

Special Notes (Anything you'd like to tell us so that we can get to know you better?) (optional)

Payment Information

Pre-authorized payment can be arranged from a visa/mastercard or bank account. Payments will be due September 15th to June 15th inclusive. Please see the guide for more information.

Credit Card Payment (optional)

Cardholder's Name (optional)

Credit Card Number (optional)

Expiry Date (optional)

CCV (3 digits on the back) (optional)

Electronic Funds Transfer From Account (optional)

Bank Name (optional)

Account Number (optional)

Transit Number (5 digits) (optional)

Account Holder's Name (optional)

Participation Waiver

I understand that participation in a dance program involves risk of injury and deem the participant in an appropriate physical condition for these activities and know of no reason that would prevent the participant from engaging. I authorize Miss Jennie’s Performing Arts Studio Inc. to secure any emergency medical treatment my child or I might need. I agree to indemnify and hold harmless Miss Jennie’s Performing Arts Studio Inc. and its staff from any and all claims to personal injury sustained while participating in this program. I agree I will not hold Miss Jennie’s Performing Arts Studio Inc. responsible for the loss or damage of personal property while in attendance and/or participating in this program. The participant acknowledges and understands that all areas of the facility are not supervised at all times and that the participant releases Miss Jennie’s Performing Arts Studio Inc., its employees, officers, director and agents from all claims arising from participation in any program in or use of studio facilities. If you wish to cancel this contract, you may do so by written notice. Non-attendance is not considered sufficient notice. Tuition fees are due without regard for attendance or classes missed. Refunds will not be given for classes missed due to participant absence or vacation. All fees incurred in the term are due to Miss Jennie’s on the deadlines agreed upon.

I agree to the terms of this waiver

Which class/program are you signing up to attend?

THANK YOU! We look forward to seeing you soon!

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