sign up today New Student Registration Form Dance Class InformationChoose Location *Please select an optionNorth EastNorth WestLocation - North WestAge Group *Please select an optionKids (5-12 years old)AdultsDance Form *Please select an optionKathakBollywoodHow Often *Please select an option$75/mo for Once a week$95/mo for twice a weekLocation - North EastAge Group *Please select an optionBeginners to Intermediate (5-7 years old)Beginners Level (7-12 years old)Beginners to intermediate (7-12 years old)Beginners to Intermediate (8 years to 15 years)Beginners to Intermediate (8 years to adults)Intermediate to Advance (10-16 years old)Advance Group (10-16 years old)Adults Only (Any Level)Adults Couple (Beginners)Dance FormBollywood/HiphopDance FormBollywood FusionBollywood/HiphopDance FormKathakDance FormBhangraDance FormBollywood/HiphopDance FormBollywood FusionDance FormKathakDance FormBollywood/HiphopDance FormZumbaKathakDance FormZumbaHow Often *Please select an option$75/mo for Once a week$95/mo for twice a week (same dance form)$130/mo for thrice a week (same dance form)$239 for three monthsHow Often *Please select an option$75/mo for Once a week$95/mo for twice a week (same dance form)$130/mo for thrice a week (same dance form)How Often *Please select an option$139 per monthStudent InformationExpected Start Date *Student's Name *Date of Birth *Address *City *Please select an optionAirdrieBeaumontBrooksBlack DiamondCalgaryCamroseChestermereCold LakeEdmontonFort SaskatchewanGrande PrairieHigh RiverLacombeLeducLethbridgeLloydminsterMedicine HatNantunOkotoksRed DeerSpruce GroveSt. AlbertVulcanWetaskiwinOtherProvince *Please select an optionAlbertaPostal Code *Primary Phone No. *Primary Email Address *Emergency ContactPerson Name *Contact No. *Relation *Legal Release & Policy Acceptance (please check this)I/we understand the Studio PolicyI/we understand my billing obligationsI/we understand the risks related to danceI/we understand my responsibilities for my propertyI/we understand the scheduleI/we give media use rights permissionMedicalAny Allergies *Will your child require any special medical attention during a normal class: (Yes/No) *YesNoIf Yes - Please Explain *By signing this form, I understand my child may be photographed while at the dance school or at events. Gurukul Dance Studio will request my permission to use my child's image(s) for promotional purposes.I agree that I will not hold Gurukul Dance Studio responsible for any injury or loss of belonging(s).Signature/Responsible Party *Date * Payment Option *Pay Now (Credit Card/Debit Card)Pay Later (Credit Card/Debit Card)Payment DetailsSubtotal$GST$Services Charges$Total Amount$*GST & Service charges appliedHave a coupon codeType hereDiscounted Amount$GST$Services Charges$Discounted Total Amount$Payment DetailsSubtotal$GST$Services Charges$Total Amount$*GST & Service charges appliedHave a coupon codeType hereDiscounted Amount$GST$Services Charges$Discounted Total Amount$Payment DetailsSubtotal$GST$Services Charges$Total Amount$*GST & Service charges appliedHave a coupon codeType hereDiscounted Amount$GST$Services Charges$Discounted Total Amount$Payment DetailsSubtotal$GST$Services Charges$Total Amount$*GST & Service charges appliedHave a coupon codeType hereDiscounted Amount$GST$Services Charges$Discounted Total Amount$Credit / Debit Card *Submit ApplicationPlease do not fill in this field.