Registration Form
Winter 2007 Semester

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 January 12, 2007.

Name:____________________________________________

Address:_________________________________________

Postal Code:__________________ Phone_____________

E-mail: ________________________________________

Please register me for:

NOTE: Prices include GST

Thurs. Beginners Ages 4-5
10 weeks		TBA _____ $250.00
Thurs. Beginners Ages 6-7
10 weeks		Thurs: 6:10-7:00 pm _____ $250.00
Thurs. Beginners Ages 8-9
10 weeks		Thurs: 7:10-8:10 pm _____ $250.00

Amount Enclosed (payable to Jazz Moves)$_______

How Did you Hear About our classes?
_____ Friend/Word of Mouth
_____ E-mail
_____ Yellow Pages
_____ Campus Rec Guide
_____ Theatre Alberta Ad
_____ Previous Jazz Moves Student
_____ At Orchesis Modern Classes
_____ Posters on Campus
_____ See/Vue Magazine
_____ Internet (pls specify search engine and key words)

_____________________________________________

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

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