Winter 2021 - Our Studio Registration Form
Welcome! We are so happy that you've decided to sign up for one or more of the programs at Our Studio! Please fill out the information below so we can get to know you a little bit better then send it our way. Please also fill out this form as many times as you need to!

If you have any questions, you can always reach us at info@ourstudiokw.com or call Lori at 519-501-6747 or Cristin at 226-600-9162. We'll see you soon!
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Email *
Today's Date: *
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PARTICIPANT INFORMATION
Participant's First Name *
Participant's Last Name *
Date of Birth *
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Language Preference *
Phone Number
PARENT/GUARDIAN INFORMATION (if applicable)
Parent/Guardian Name (first & last) *
Parent/Guardian Phone Number *
Parent/Guardian Work Number
VIRTUAL SESSIONS @ OUR STUDIO VIA ZOOM
Please let us know what program/s you would like to register for? If you would like to register for more program/s in the future, just come back and fill out this form again!
Our Studio Morning Connection - Mon-Fri, 10:30 - noon  
Our Studio Daily Revue - Mon-Fri, 1:00 - 2:30 p.m.
Healthy Fit Fun - Wednesdays, 6:30-8:00 p.m.
Friend Zone  - every Thursday *You can purchase a “Friend Zone Pack” which includes 5 passes each for $100 (to be used by March 31, 2021). Just show up on Zoom and the Facilitator will take note of the participants and passes will be deducted (1 per session) and tracked by Our Studio.
Karaoke Party -  NOW every Saturday night! *You can purchase a “Karaoke Party Pack” which includes 5 passes each for $100 (to be used by March 31, 2021). Just show up on Zoom and the Facilitator will take note of the participants and passes will be deducted (1 per session) and tracked by Our Studio.
Our Zoom link is the same for all of our programs! What email would you like us to send it to? *
Payment
Once you complete and submit this form, you will receive an invoice at the end of the month for the program/programs that have been registered for. Please let us know how you would like to make a payment so we can send your invoice to the right place.
How would you like to pay? *
If choosing to pay with SSAH or Passport Funding, I give permission for Our Studio to invoice Extend-A-Family Waterloo Region on my child's behalf to cover the registration fee. Please type your name below. Please note that you will also have to set this up with your Extend-A-Family Support Coordinator.
Photo Release - I consent to have my photo (or my child's photo) taken during the program, including headshots and photos taken during performances, and used for promotional purposes. I understand that photos may be used on social media, online and in print format. *
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