Registration Form
Summer Session

Please note that electronic on-line registration is not yet possible. Please print out this registration, fill it in and mail along with payment to:

Jazz Moves
4830-104A Street
Edmonton AB T6H 5Z1

Contact us at: [email protected].

Registration Deadline is July 16 for Weeks One and Two and July 30 for Week Three.

Name:____________________________________________

Address:_________________________________________

Postal Code:__________________ Phone_____________

E-mail: _________________________________________

Please register me for (please check the appropriate days) and place an X in the payment box below):

Week 1: ___M ___T ___W ___R ___F (Beg/Int Jazz 6:00)
Week 1: ___M ___T ___W ___R ___F (Int/Adv Jazz 7:40)

Week 2: ___M ___T ___W ___R ___ F(Hip Hop Beg. 6:00)
Week 2: ___M ___T ___W ___R ___ F(Hip Hop Exp. 7:30)

Week 3: ___T ___W ___R ___F (B/I Jazz 6:00)
Week 3: ___T ___W ___R ___F (I/A Jazz 7:40)

# Classes Hip Hop OR
Beg/Int Jazz		Int/Adv
Jazz
1 class15 20
2 classes30 40
3 classes45 60
4 classes 48 60
5 classes 60 75
6 classes 75 95
7 classes 90 115
8 classes 105 125
9 classes 108 135
10 classes 123  
11 classes 138  
12 classes 153  
13 classes 156
14 classes 168  

Amount Enclosed (payable to Jazz Moves)$_______

How Did you Hear About our classes?
_____ Friend/Word of Mouth
_____ Yellow Pages
_____ Campus Rec Guide
_____ Theatre Alberta Ad
_____ Previous Jazz Moves Student
_____ At Orchesis Modern Classes
_____ Posters on Campus
_____ See/Vue Magazine
_____ Other (pls specify)

_____________________________________________

Mail completed form along with payment to:
Jazz Moves
4830-104A Street
Edmonton AB T6H 5Z1

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