APRIL/MAY 2023 Registration - The Heels Academy
Session Timing: MONDAYS - Starting April 3, 2023
Session Length: 6-weeks (April 3 to May 8, 2023)
Address: The Heels Academy at GBHS (83 Essex St, Guelph)

Class Times: **NEW CLASS TIMES!!!**
- THA BABES - 6:30pm to 8:00pm (Beginner)
- THA FIERCE - 8:15pm to 9:45pm (Intermediate & up)

6-Week Registration Cost: $140
- Payment plan available, details below

Any Questions?  Contact us at theheelsacademy@gmail.com
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Email *
Full Name (First and Last) *
Preferred Pronouns (i.e. she/her, they/them, etc.) *
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Instagram Handle (@_______) *
I am 18 years of age or older *
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I am registering for:

** Please note that classes and dancers may be re-assigned based on registration numbers **
 *
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I understand I need to make a payment of either $40 for pay plan participants or the full $140 for my session registration upon completion of this registration to secure my spot. I understand that if this is not complete my registration will be void. Payments can be sent via Interac e-transfer  to theheelsacademy@gmail.com (no password required) Also, we do not accept Paypal. Please make note of these instructions! *
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Would a payment plan of three (3) payments be helpful for you? Payments are as follows:
- $40 upon registration
- $50 by April 3rd
- $50 by April 24th

***Please make note of these dates!
*
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I acknowledge that the "2023 April/May Session" membership fees ($140) are non-refundable unless classes are required to shut down due to another COVID-19 outbreak, or a recommendation or order from Public Health and/or the Government of Ontario. If a shutdown occurs, a pro-rated credit will be issued and applied to the next session when classes are safe to resume. If a dancer cannot continue, a refund will be offered. A one-time credit for non-COVID reasons may be requested should a dancer be unable to continue in the dance program.
 *
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By checking the box below you acknowledge that this form is an electronic Acknowledgment and Release waiver. This form can only be completed by the individual named above. *
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By checking the box below you acknowledge that your participation in the dance class offered by The Heels Academy ("THA") could involve possible personal injury as well as possible risk for contracting COVID-19. By signing this release form, you assume all risks in connection with participating in classes held by The Heels Academy. You also agree to not hold any affiliate parties of THA, Guelph Black Heritage Society, Heritage Hall, or any other class location owners liable for any injury, damages, or losses in connection with your participation in classes held by The Heels Academy. *
Required
By checking the box below you hereby authorize The Heels Academy ("THA") and any affiliate parties of The Heels Academy to utilize photographs, videos and recordings of you either captured by THA and its affiliates or provided by you to THA in any promotional material, including but not limited to social media websites and outlets, brochures, promotional videos and posters. You hereby release and discharge THA of and from any and all claims, demands, and causes of action, liability, damages, and losses of any kind and nature that arise directly or indirectly from the use of my name and/or the images. The images are to be used exclusively by THA and may not be sold, licensed or otherwise transferred by THA. *
Required
In order to protect myself, and THA community, I will not come to class if sick with any cold, flu, or other illness(es).

Pertaining to COVID-19, I will adhere to any applicable measures established by The Heels Academy and/or as outlined by the current Public Health rules on the date of any given class.     >>> For more information, please refer to the Ontario COVID website: https://covid-19.ontario.ca/exposed
 *
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I fully understand and acknowledge that the The Heels Academy is relying on the statements above and that my participation in The Heels Academy is conditioned upon this acknowledgement, waiver, and release form. *
Required
Helpful class information for new and returning dancers:
You can check out our welcome package with helpful information by following this link. Thanks!
We look forward to welcoming you back to the studio and we thank you for supporting us!                                                                                                With Love, Kween, Vanessa & Michelle
A copy of your responses will be emailed to the address you provided.
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