Test 1 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 FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin 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 ($240 / month) 7 classes ($270 / month) 8 or more classes ($295 / month) Unlimited Classes Package* 6 classes ($175 / month) 7 classes ($195 / month) 8 or more classes ($210 / 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/Jr Jazz Company (ages 8-12) - Tuesday 5:00pm-6:00pm 57.00/mth Mini Jazz Company - Friday 4:45pm-5:30pm 47.00/mth Int./Sr. Jazz Company (ages 14-17) - Thursday 4:00 - 5:00pm 57.00/mth JAZZ (Sept. to May) Petite/Jr Jazz Company (ages 8-12) - Tuesday 5:00pm-6:00pm Mini Jazz Company - Friday 4:45pm-5:30pm Int./Sr. Jazz Company (ages 14-17) - Thursday 4:00 - 5:00pm HIP HOP - (Sept. to May)HIP HOP - (Sept. to May) Petite/Jr Hip Hop Company- Tuesday 6:00pm-6:45pm 47.00/mth Int./Sr. Hip Hop Company - Thursday 5:00pm-5:45pm 47.00/mth HIP HOP - (Sept. to May) Petite/Jr Hip Hop Company- Tuesday 6:00pm-6:45pm Int./Sr. Hip Hop Company - Thursday 5:00pm-5:45pm ACRODANCEACRODANCE - (Sept. to May) Petite/Jr Acro Company (ages 8-12) - Tuesday 4:00pm-5:00pm 57.00/mth Int./Sr. Acro Company (age 13 - 17) - Thursday 5:45 - 6:45pm 57.00/mth ACRODANCE - (Sept. to May) Petite/Jr Acro Company (ages 8-12) - Tuesday 4:00pm-5:00pm Int./Sr. Acro Company (age 13 - 17) - Thursday 5:45 - 6:45pm BALLET - (Sept. to May)BALLET - (Sept. to May) Petite/Jr Ballet Company (age 8-12) - Tuesday 6:45pm - 7:30pm 47.00/mth Int./Sr. Ballet Company (age 13 - 17) - Wednesday 7:15pm - 8:00pm 47.00/mth Petite/Jr Ballet Technique - Wednesday 4:45pm - 5:30pm 47.00/mth Int/Sr Ballet Technique - Wednesday 6:15pm - 7:15pm 57.00/mth BALLET - (Sept. to May) Petite/Jr Ballet Company (age 8-12) - Tuesday 6:45pm - 7:30pm Int./Sr. Ballet Company (age 13 - 17) - Wednesday 7:15pm - 8:00pm Petite/Jr Ballet Technique - Wednesday 4:45pm - 5:30pm Int/Sr Ballet Technique - Wednesday 6:15pm - 7:15pm POINTE - (Sept. to May)POINTE - (Sept. to May) PrePointe / Pointe - Wednesday 5:30pm - 6:15pm 47.00/mth POINTE - (Sept. to May) PrePointe / Pointe - Wednesday 5:30pm - 6:15pm TAP - (Sept. to May)TAP - (Sept. to May) Petite/Jr Tap Company - Tuesday 7:30pm-8:15pm 47.00/mth Int./Sr. Tap Company (ages 13 and up) - Thursday 7:30pm-8:15pm 47.00/mth TAP - (Sept. to May) Petite/Jr Tap Company - Tuesday 7:30pm-8:15pm Int./Sr. Tap Company (ages 13 and up) - Thursday 7:30pm-8:15pm LYRICAL - (Sept. to May)LYRICAL - (Sept. to May) Petite/Jr Lyrical - Wednesday 4:00 - 4:45pm 47.00/mth Int./Sr. Lyrical Company (ages 14 and up) - Thursday 6:45pm-7:30pm 47.00/mth LYRICAL - (Sept. to May) Petite/Jr Lyrical - Wednesday 4:00 - 4:45pm Int./Sr. Lyrical Company (ages 14 and up) - Thursday 7:45pm-8:30pm CONTEMPORARY - (Sept. to May)CONTEMPORARY - (Sept. to May) Int./Sr. Contemporary Company (ages 14 and up) - Wednesday 8:00pm-8:45pm 47.00/mth CONTEMPORARY - (Sept. to May) Int./Sr. Contemporary Company (ages 14 and up) - Wednesday 8:00pm-8:45pm Would you also like to register for any recreational classes? Yes No Recreational ClassesHIP HOP - (Sept. to May)HIP HOP - (Sept. to May) Junior/Int Hip Hop (ages 8-11) - Monday 5:30pm-6:15pm 47.00/mth Teen Hip Hop Friday 5:30pm - 6:15pm 47.00/mth HIP HOP - (Sept. to May) Junior/Int Hip Hop (ages 8-11) - Monday 5:30pm-6:15pm Teen Hip Hop Friday 5:30pm - 6:15pm JAZZ - (Sept. to May)JAZZ - (Sept. to May) Junior/Int Jazz (ages 8-11) - Monday 6:15 - 7:00pm 47.00/mth Teen Jazz (ages 12+) - Friday 6:15 - 7:00pm 47.00/mth JAZZ - (Sept. to May) Junior/Int Jazz (ages 8-11) - Monday 6:15 - 7:00pm Teen Jazz (ages 12+) - Friday 6:15 - 7:00pm BALLET - (Sept. to May)BALLET - (Sept. to May) Junior Ballet (age 8-12) - Friday 4:00pm - 4:45pm 47.00/mth BALLET - (Sept. to May) Junior Ballet (age 8-12) - Friday 4:00pm - 4:45pm TAP - (Sept. to May)Tap / Musical Theatre - (Sept. to May) Junior/Int Tap/Musical Theatre (ages 8-11) - Monday 7:00pm-7:45pm 47.00/mth Teen Musical Theatre (ages 12+) - Friday 7:00pm-7:45pm 47.00/mth Tap / Musical Theatre- (Sept. to May) Junior/Int Tap/Musical Theatre (ages 8-11) - Monday 7:00pm-7:45pm Teen Musical Theatre (ages 12+) - Friday 7:00pm-7:45pm ACRODANCE - (Sept. to May)ACRODANCE - (Sept. to May) Acrodance Level 1-2: Monday 4:45pm-5:30pm 47.00/mth Acrodance Level 3-4: Monday 4:00pm-4:45pm 47.00/mth ACRODANCE - (Sept. to May) Acrodance Level 1-2: Monday 4:45pm-5:30pm Acrodance Level 3-4: Monday 4:00pm-4:45pm 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 4 years or younger. No refunds after March 1st. In the Event of a Pandemic, classes will go Online until further noticeIf 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 COMPETITIVE FEE Price: 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