By checking this box I give permission for my child to attend classes at
Kids Can Dance Studio.
I release the staff of any liability in the event of an accident or illness during
time in their class or studio event.
I release them to take appropriate action should they need emergency medical treatment.
I give consent to receive electronic mail and for photos/videos to be taken during
class or studio events and recognize that these may be used for future promotional
Rhythm and Movement (2 ½ - 4 years )
I would like to register for the following classes:
Dancer’s First Name
A $15 Registration fee is charged once per dance season for all Sessional classes.
Registration fees are due at the time of registration. Registration fees are non-
Once you click submit, information regarding payment will be available.
Health Card #
Please explain any previous dance experience if applicable:
** Must have no spaces
Dancer’s Last Name
Are there any health concerns, allergies or previous injuries that Kids Can Dance
staff should be aware of? If so, please list:
Parent & Tot (18 mos-3 years)
Preschool Acro (3-4 years )
Adult Contemporary Ballet (16+ years )
1350 Cornwall St. Regina, SK 306-721-7837