How many dancers are you registering? *

1 - Cost = CAD $600

2 - Cost = CAD $1200

3 - Cost = CAD $1800

Dancer 1 - Name *

First Name

Last Name

Dancer 1 - Date of birth *

MM

DD

YYYY

Dancer 1 - Did this dancer arrive in Canada from Ukraine on or after February 24th, 2022? *

Yes

No

Dancer 2 - Name

Proceed to section 3 if only registering 1 dancer

First Name

Last Name

Dancer 2 - Date of birth

MM

DD

YYYY

Dancer 2 - Did this dancer arrive in Canada from Ukraine on or after February 24th, 2022?

Yes

No

Dancer 3 - Name

First Name

Last Name

Dancer 3 - Date of birth

MM

DD

YYYY

Dancer 3 - Did this dancer arrive in Canada from Ukraine on or after February 24th, 2022?

Yes

No

Parent / Guardian - Name *

First Name

Last Name

Parent / Guardian - Phone *

Country

(###)

###

####

Parent / Guardian - Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact - Name *

First Name

Last Name

Emergency Contact - Phone *

Country

(###)

###

####

Are you interested in volunterring with Desna School? *

Yes

No

If yes, please select the volunteering options that you would be interested in

Help to organise the christmas concert

Help to organise the spring concert

Lead or assist with a fundraising event

Lead or assist with christmas carolling

Other (please let us know your ideas)

*

I am enrolling my child(ren) into a program of physical activity in the form of dance offered by Desna Ukrainian Dance School (referred to as “Desna”). Classes may include, but are not limited to activities including ballet or character barre, corner work, centre work, choreography, and dance conditioning exercises. The classes may include activities such as turning/spinning, jumping, deep squatting, intense stretching, and repetitive movements. Strength, flexibility, and cardiovascular endurance will all be challenged. I accept responsibility for all possible risk of injury (see below) and hold Desna, its Instructors and Board of Directors blameless in the event of damage before, during and/or after rehearsals, trips, shows and other events, both within and outside of Desna’s studios. In the event of injury, the current instructor, and/or Desna is authorized to seek emergency medical assistance on my behalf. (Injury including, but not limited to muscle strains, pulls or tears, broken bones, shin splints, knee/hip/lower back/foot injuries, heart attacks, and any other illness, soreness, or damage, including death, however, caused) I understand that the staff and volunteers of Desna will make every effort in order to maintain a safe, positive environment for dancers. In the event that my child(ren) should observe any unsafe conduct or conditions before, during or after class, My child(ren) agrees to report the unsafe conduct or conditions to the Artistic Director, Administrator, Instructor or other Desna representative as soon as possible. I acknowledge that Desna has its own Covid-19 protocols in place and is adhering to government and rehearsal space guidelines, policies and protocols. My child(ren) is/are in good physical condition, does not suffer from any disability or physical ailment and is/are not taking medication that would cause them harm or limit their participation in dance classes. If any damage is found to the costume, I agree to pay a CAD $100 costume fee. Any personal information provided by myself is for the sole use of Desna and will not be made available to anybody (publicly or privately) without my permission. By submitting this form as an individual who wishes their child(ren) to participate in activities with Desna, I confirm that I have read and fully understood the Desna code of conduct and constitution, and agree to follow all the rules and applicable penalties outlined in these document

I agree to pay the annual membership by e-transfer (treasurer@desna.ca) and is due at the time of registration - alternative payment plans can be discussed with the treasurer.

By clicking submit, I confirm that I have read, understood and filled in the above information correctly.