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Chaban Ukrainian Dance Regina Registration 2022-2023
Classes run from September 2022 - May 2023 *Please complete - one form per dancer*
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Novice 1(Ages 3-5 years) - $35/mth Classes on Wednesdays 6:00 -7:00 PM (1hr/wk)
Novice 2 (Ages 6+ ) - $45/mth Classes on Wednesdays 7:00 -8:00 PM (1 hr/wk)
Beginner 2 - $45/mth Classes on Tuesdays 6:00 7:00 PM
Intermediate - $85/mth Classes on Mondays 6:00 -7:00 PM and Thursdays 6:00 - 7:00 PM
Youth Ensemble - $105/mth Classes on Mondays 7:30 - 9:00 PM and Thursdays 7:00-8:30 PM
Adult - $55/mth Classes on Tuesdays 7:00 - 8:00 PM
DANCER INFORMATION
Please complete
Dancer Last Name:
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Your answer
Dancer First Name:
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Your answer
Gender
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Male
Female
Birthdate: (mm/dd/year)
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Your answer
Age as of September 1, 2022
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Your answer
Address:
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Your answer
City:
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Your answer
Postal Code:
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Your answer
Phone Number:
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Your answer
Email Address:
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Your answer
Parent/Guardian (Primary Contact Information)
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Your answer
Address/Phone Number (if different from the one provided with child's information)
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Same as child's
Other:
Parent/Guardian (Secondary Contact Information-if not applicable please state n/a)
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Your answer
Address/Phone Number (if different from the one provided with child's information)
*
Same as child's
Other:
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