Shumka School of Dance 2023/2024 Registration Form

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Parents can complete registrations for up to four children using this form. Please use the class scheduling information from your 'class placement guide sheet' to complete the class selection portion of the registration form. If you did not receive a class placement guide sheet or are new to the School, please contact June Eeles at the Shumka office (780.455.9559 ext. 1)

Family Name *

Mailing Address *

City or Town *

Province *

Postal Code *

Mother's Name

Father's Name

Email #1 *

Email #2

Phone # 1 *

Phone # 2

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