Lindsay Rose Highland Dance Company
2022-2023 Registration form 
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Email *
Current Home Address
Name of dancer (1) and current age
Dancers Birth date
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Please list any allergies or medical conditions I should be aware of
Name of dancer (2) and current age 
Dancers Birth date
MM
/
DD
/
YYYY
Please list any allergies or medical conditions I should be aware of
Name of Dancer  (3) and current age
Dancers Birth Date
MM
/
DD
/
YYYY
Please list any allergies or medical conditions I should be aware of
Classes Registering for UXBRIDGE
Attn New Dancers! Your class levels are offered on Thursdays
Classes Registering for COBOURG
Classes Registering for PETERBOROUGH
Classes Registering for VIRTUAL 
My dancer is interested in:
I am interested in availability for additional private lessons for my dancer.
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My dancer requires new uniform items
Parent Contact Info - Please write Names of each parent
Emails of each parent you would like email info sent to
Parents Cell phone numbers for emergencies
Your dancers email if you would like relevant information (steps, videos ) sent to them
I am interested in hearing about the Adult class sessions
Intermediate/Premier only - My dancer has interest in 
I do / do not give consent for my child                                          to be photographed or videotaped at classes/ school outings or performances which may be used for social media and/or marketing purposes. I realize that this will affect performances they may be asked to be a part of. Please place the dancer(s) name below.
Waiver – I hereby for myself, my heirs, executors, and assigns waive and release any and all rights and claims and damages against the Lindsay Rose Highland Dance Company , or its representative Lindsay Perreault for any injuries which may be suffered by me or my child during any classes or dance functions related to the dance school. Please place the guardians full name below
Are there any additional things you'd like me to know?
Thank you ! You have almost completed the registration process. Please confirm how you will send payment.  You will receive an invoice with your total for the options selected. You will also be emailed a copy of the studio guidelines, policies, and uniform help.
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