Name *
Name
Phone *
Phone
Emergency Contact Phone *
Emergency Contact Phone
Date of Birth *
Date of Birth
Which Workshop are you registering for? *
How will you be paying *
All e-transfers are to be made to kvitkadancers@gmail.com (password 'workshop') Cheques can be made payable to Kvitka Ukrainian School of Dance and mailed to 10265 167A St, Surrey BC. V4N 5H2
Media Release *
I hereby give consent for the registrant to be photographed or filmed for the use of Kvitka Ukrainian School of Dance
Liability *
I understand that Kvitka Ukrainian School of Dance is not responsible for any injuries that may occur during the workshop
Terms and Conditions *
I have read the terms and conditions