Recreational Registration Teknique School of Dance 2026/2027

Student’s Name

First NameLast Name

Student’s birth date

Date

Student’s age by December 31, 2026

Primary Parent or Guardian

First NameLast Name

Primary contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Primary contact Email

example@example.com

Secondary parent or guardian/emergency contact

First NameLast Name

Secondary/ Emergency Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Tuesday classes

Wednesday classes

In consideration of my child and myself being registered at Teknique School of Dance, I undersigned release, waive and forever discharge Teknique School of Dance and all of the respective employees, volunteers and the principal against all claims or demands whatsoever for any injury, loss or damage sustained by the child and or myself, however caused, arising out of or in connection to Teknique School of Dance.I have received a copy of Teknique School of Dance’s policies, which express refund policies, and dress code, and I agree that we shall abide by the rules set forth. By signing and submitting this form, and on behalf of my son/daughter and or myself, I acknowledge having read and agreed to the above released

MEDIA RELEASE FORM FOR ONLINE PURPOSES: I, the undersigned, hereby grant permission to the Teknique School of Dance to photograph, and or record my son/daughter/myself on video or tape, and use this material in whole or in part, to promote the Teknique School of Dance, through media, film, internet, or in printed form. I understand that the visual material and the copyright therein will remain the sole property of Teknique School of Dance. I further waive any claim to remuneration for use of this visual material used for there purposes.

I understand that the recital is recorded for distribution to all families who have registered at Teknique School of Dance. Should I not want my child recorded for this purpose I will withdraw my child from dancing at the recital.

Were you referred by anybody?

Any other information we should know? Eg. Allergies, medical conditions, injuries, disabilities etc…

Please Choose A Payment Option

No Registration will be considered complete until Registration and Recital fees have been received total of $45.00. Every Class will participate in our year end recital with an extra costume cost. Deposits are $60.00 due by September 30th and are non refundable after this date. The costume balance will be sent by March 30th, No costumes will go home until all balnces have been paid.
Please check our website for pricing. All lessons will be invoiced. All lesson payments and fees can be sent by e-transfer to teknique5678@gmail.com
All payments require a question and answer. Please keep them simple.
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