Registration

NOTE: Registration is complete only upon return of this form and full fee payment. For a printable version, please click SignUpForm.

* = required field

student
child’s name*:   date of birth*:
age*:   school*:   grade*:  

parent/guardian
name*:   home #*:  
bus #:   cell #*:  
email*:  
address*:  
city*:   province*:   postal code*:  
persons authorized to pick up child*:   relationship*:  

emergency contact
name*:   phone #(s)*:  
email:  
relationship*:  

provincial health card info
health card #:   code:  

medical concerns & help info
Are there any allergies or medical concerns regarding you or your child that we need to be aware of? Please list any helpful information (ie: previous experience for new students, learning difficulties, concerns)*

How did you hear of us?
To help with promos, please be so kind as to let us know how you found us (ie: internet, flyer, friend, Little Paper etc:  

programs
list the classes you are registering for*:  
day*:   time*:   fee*: $ 
list the classes you are registering for:  
day:   time:   fee: $ 
list the classes you are registering for:  
day:   time:   fee: $ 
Discounts: (Choose one and subtract from total)
    — Multiple Class Discount (multiple classes for one student) 10% off session of lesser value: $ 
    — OR Family Discount (after first full price child, additional children from the same household) 10%: $ 
Registration Fee (add to total: + $25 )*: $25.00 ($15 for camp)
HST (please add to total: + 13% )*: $ 
Grand Total/Payment Amount*: $ 
Payment Method*:  cash cheque email money transfer

All class placements are at the teacher’s discretion and The Centre For Art & Soul reserves the right to change them if necessary.

Although every effort is made to ensure student safety, there are risks due to the physical nature of some of the classes and injuries may occur. Teachers must be informed if a student is unable to fully participate in class for any reason. The Centre For Art & Soul and any individual teacher at The Centre cannot be held responsible for injuries sustained due to participation in class, however caused.

 * is capable of participating in all activities at The Centre For Art & Soul. I have read and understand the above, and assume all risks and responsibilities. I have read and understand The Centre Policies on-line, and agree to abide by them. I hereby release The Centre For Art & Soul, and all individuals teaching at The Centre, from any and all liability. I give permission for my child’s picture to appear in promotional material for The Centre For Art & Soul. I also understand that during performances, pictures and/or video may be recorded of me/my child by 3rd parties, and The Centre has no control over and assumes no responsibility for the practices of any 3rd party. I expressly relieve The Centre For Art & Soul from any and all liability arising from the practices of any 3rd party.

Signature of Parent/Guardian*:     Date*:  
Cheques and registration forms can be made payable and mailed to “The Centre For Art & Soul”, 12 Laxton Ave. Toronto ON, M6K 1K9