Competitive Registration Child's Name* Birth Date* MM slash DD slash YYYY Age*School Medical InformationMedical ConditionsContact InformationParent(s) or legal guardian* Email* Phone*Emergency Phone*Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country ClassesCheck the boxes beside the classes you wish the above child to be registered for. Your total due will be calculated below.Would you like to sign up for our unlimited classes package?We offer large discount if you sign up for 6 or more classes Yes No Is this registration for the 2nd sibling registered in the same family? Yes No Name of first registered child Unlimited Classes Package* 6 classes ($225 / month) 7 classes ($250 / month) 8 or more classes ($275 / month) Unlimited Classes Package* 6 classes ($165 / month) 7 classes ($185 / month) 8 or more classes ($200 / month) Please choose 6 classes from the list belowPlease choose 7 classes from the list belowPlease choose 8 or more classes from the list belowCompetitive ClassesJAZZ (Sept. to May)JAZZ (Sept. to May) Petite/Junior Jazz Company (ages 7-10) - Tuesday 6:15pm-7:00pm 45.00/mth Int./Sr. Jazz Company (ages 11-17) - Thursday 7:00 - 7:45pm 45.00/mth WAIT LIST: Int./Sr.Jumps & Turns - Thursday 7:45pm - 8:30pm 45.00/mth Petite/Jr.Jumps & Turns - Tuesday 7:00pm -7:30pm 45.00/mth JAZZ (Sept. to May) Petite/Junior Jazz Company (ages 7-10) - Tuesday 6:15pm-7:00 Int./Sr. Jazz Company (ages 11-17) - Thursday 7:00 - 7:45pm WAIT LIST: Int./Sr.Jumps & Turns - Thursday 7:45pm - 8:30pm Petite/Jr.Jumps & Turns - Tuesday 7:00pm -7:30pm HIP HOP - (Sept. to May)HIP HOP - (Sept. to May) Petite/Junior Hip Hop Company (ages 7-10) - Tuesday 4:00pm-4:45pm 45.00/mth Int./Sr. Hip Hop Company (ages 11-17) - Thursday 6:15pm-7:00pm 45.00/mth HIP HOP - (Sept. to May) Petite/Junior Hip Hop Company (ages 7-10) - Tuesday 4:00pm-4:45pm Int./Sr. Hip Hop Company (ages 11-17) - Thursday 6:15pm-7:00pm ACRODANCEACRODANCE - (Sept. to May) Petite/Junior Acro Company (ages 7-10) - Monday 4:00pm-4:45pm 45.00/mth Int./Sr. Acro Company (age 11 and up) - Thursday 5:30 - 6:15pm 45.00/mth ACRODANCE - (Sept. to May) Petite/Junior Acro Company (ages 7-10) - Monday 4:00pm-4:45pm Int./Sr. Acro Company (age 11 and up) - Thursday 5:30 - 6:15pm BALLET - (Sept. to May)BALLET - (Sept. to May) Petite/Junior Ballet Company (age 7-10) - Wednesday 4:45pm - 5:30pm 45.00/mth Int./Sr. Ballet Company (age 11 and up) - Wednesday 6:15pm - 7:00pm 45.00/mth BALLET - (Sept. to May) Petite/Junior Ballet Company (age 7-10) - Wednesday 4:45pm - 5:30pm Int./Sr. Ballet Company (age 11 and up) - Wednesday 6:15pm - 7:00pm POINTE - (Sept. to May)POINTE - (Sept. to May) Pointe Company - Wednesday 7:45pm - 8:30pm 45.00/mth POINTE - (Sept. to May) Pointe Company - Wednesday 7:45pm - 8:30pm TAP - (Sept. to May)TAP - (Sept. to May) Petite/Junior Tap Company (ages 7-10) - Tuesday 5:30pm-6:15pm 45.00/mth Int./Sr. Tap Company (ages 11 and up) - Tuesday 7:00pm-7:45pm 45.00/mth TAP - (Sept. to May) Petite/Junior Tap Company (ages 7-10) - Tuesday 5:30pm-6:15pm Int./Sr. Tap Company (ages 11 and up) - Tuesday 7:00pm-7:45pm LYRICAL - (Sept. to May)LYRICAL - (Sept. to May) Int./Sr. Lyrical Company (ages 11 and up) - Tuesday 7:45pm-8:30pm 45.00/mth LYRICAL - (Sept. to May) Int./Sr. Lyrical Company (ages 11 and up) - Tuesday 7:45pm-8:30pm CONTEMPORARY - (Sept. to May)CONTEMPORARY - (Sept. to May) WAIT LIST: Int./Sr. Contemporary Company (ages 11 and up) - Wednesday 7:00pm-7:45pm 45.00/mth CONTEMPORARY - (Sept. to May) WAIT LIST: Int./Sr. Contemporary Company (ages 11 and up) - Wednesday 7:00pm-7:45pm CECCHETTI BALLET EXAM - (Sept. to May)CECCHETTI BALLET EXAM - (Sept. to May) Petite/Junior Cecchetti Ballet Exam (age 7-10) - Thursday 5:30-6:15pm 45.00/mth WAIT LIST: Int./Sr. Cecchetti Ballet Exam (age 11 and up) - Thursday 4:00pm-4:45pm 45.00/mth CECCHETTI BALLET EXAM - (Sept. to May) Petite/Junior Cecchetti Ballet Exam (age 7-10) - Thursday 5:30-6:15pm WAIT LIST: Int./Sr. Cecchetti Ballet Exam (age 11 and up) - Thursday 4:00pm-4:45pm Recreational ClassesDANCE CONDITIONING - (Sept. to May)DANCE CONDITIONING - (Sept. to May) WAIT LIST: Mini/Petite/ Jr. Dance Conditioning (ages 6-10) - Wednesday 5:30pm-6:15pm 45.00/mth Int./Sr. Dance Conditioning (ages 10-18) - Wednesday 4:45pm-5:30pm 45.00/mth DANCE CONDITIONING - (Sept. to May) WAIT LIST: Mini/Petite/ Jr. Dance Conditioning (ages 6-10) - Wednesday 5:30pm-6:15pm Int./Sr. Dance Conditioning (ages 10-18) - Wednesday 4:45pm-5:30pm Tumbling and Tricks - (Sept. to May)Tumbling and Tricks - (Sept. to May) Mini/Petite/ Jr. Tumbling & Tricks - Wednesday 5:30 to 6:15pm 45.00/mth Int./Sr. Tumble & Tricks - Wednesday 4:00 to 4:45pm 45.00/mth Tumbling and Tricks - (Sept. to May) Mini/Petite/ Jr. Tumbling & Tricks - Wednesday 5:30 to 6:15pm Int./Sr. Tumble & Tricks - Wednesday 4:00 to 4:45pm HIP HOP - (Sept. to May)HIP HOP - (Sept. to May) Junior Hip Hop - Level 1 (ages 7-10) - Tuesday 5:30pm-6:05pm 45.00/mth Junior Hip Hop - Level 2 (ages 7-10) - Monday 4:45pm-5:20pm 45.00/mth Int./Teen Hip Hop (ages 11-17) - Monday 5:30 - 6:05pm 45.00/mth HIP HOP - (Sept. to May) Junior Hip Hop - Level 1 (ages 7-10) - Tuesday 5:30pm-6:05pm Junior Hip Hop - Level 2 (ages 7-10) - Monday 4:45pm-5:20pm Int./Teen Hip Hop (ages 11-17) - Monday 5:30 - 6:05pm JAZZ - (Sept. to May)JAZZ - (Sept. to May) Junior Jazz (ages 7-10) - Tuesday 4:45 - 5:20pm 45.00/mth Int./Teen Jazz (ages 11-17) - Monday 4:00 - 4:35pm 45.00/mth JAZZ - (Sept. to May) Junior Jazz (ages 7-10) - Tuesday 4:45 - 5:20pm 45.00/mth Int./Teen Jazz (ages 11-17) - Monday 4:00 - 4:35pm 45.00/mth BALLET - (Sept. to May)BALLET - (Sept. to May) Junior Ballet (age 7-10) - Tuesday 6:15pm - 6:40pm 45.00/mth BALLET - (Sept. to May) Junior Ballet (age 7-10) - Tuesday 6:15pm - 6:40pm 45.00/mth TAP - (Sept. to May)TAP - (Sept. to May) Junior Tap Company (ages 7-10) - Tuesday 5:30pm-6:05pm TAP - (Sept. to May) Junior Tap Company (ages 7-10) - Tuesday 5:30pm-6:05pm ACRODANCE - (Sept. to May)ACRODANCE - (Sept. to May) Junior Acrodance 1-2 (ages 7-10) - Tuesday 4:00pm-4:35pm Int./Teen Acrodance (ages 11-17) - Monday 5:30pm-6:05pm Mini/Petite/ Jr. Acro Strength & Flexibility (age 7-10) — Wednesday 7:00 - 7:45pm Int./Sr. Acro Strength & Flexibility (age 11 and up) - Thursday 7:30 - 8:15pm ACRODANCE - (Sept. to May) Junior Acrodance 1-2 (ages 7-10) - Tuesday 4:00pm-4:35pm Int./Teen Acrodance (ages 11-17) - Monday 5:30pm-6:05pm Mini/Petite/ Jr. Acro Strength & Flexibility (age 7-10) — Wednesday 7:00 - 7:45pm Int./Sr. Acro Strength & Flexibility (age 11 and up) - Thursday 7:30 - 8:15pm MUSICAL THEATRE - (Sept. to May)MUSICAL THEATRE - (Sept. to May) Junior Musical Theatre (age 7-10) - Monday 7:00pm-7:35pm 45.00/mth MUSICAL THEATRE - (Sept. to May) Junior Musical Theatre (age 7-10) - Monday 7:00pm-7:35pm LYRICAL - (Sept. to May)LYRICAL - (Sept. to May) Petite/Jr. Lyrical (ages 7 - 10) - Tuesday 7:45pm-8:30pm LYRICAL - (Sept. to May) Petite/Jr. Lyrical (ages 7 - 10) - Tuesday 7:45pm-8:30pm TRIPLE THREAT - (Sept. to May)TRIPLE THREAT - (Sept. to May) Int./Teen Triple Threat (age 11 up) - Monday 4:45pm-5:20pm TRIPLE THREAT - (Sept. to May) Int./Teen Triple Threat (age 11 up) - Monday 4:45pm-5:20pm PaymentPayment Option* Full Payment Monthly Payments Payment Method* Credit Card E-Transfer Cheque If you would like to set up optional payment arrangements, contact the studio. Fees non-refundable. Exceptions are made with a Doctors note stating medical reason or student is 5 years or younger.If you are paying by cheque, payment must be delivered to the studio before we can add the child to the class.Subtotal $ 0.00 CAD Tax $ 0.00 CAD Total $ 0.00 CAD Monthly Payment Price: $ 0.00 CAD Release & LiabilityI hereby agree to not hold Jennifer Johns Main and staff responsible for any damages or liability due to theft, accident, or injury during or resulting from my child’s participation in any capacity of or relating to any function or activity of the said JJ Dance Performing Arts Studio. I/We give JJ Dance Performing Arts Studio permission to use any pictures video taken of me, or my child for advertising purposes.* I agree to the above terms Credit CardCard Details Cardholder Name