Participant Name (First and Last Name)

Health Card #

Date of Birth (format: dd/mm/yyyy)

Participant Age (format: Years Old)

Does your child have any special physical or emotional needs we should be aware of?


Registering Parent Name (First and Last Name)

Cell Phone



Day Time Class $110
7 Weeks
30 minute class
7 Weeks
45 minute class
Monday 3:15-4:00 Parent and Me Toddler Gymnastics
Monday 5:30-6:15 Acrobatics ages 5-6
Monday 6:20-7:05 Ballet ages 5-6
Monday 7:10-7:55 Ballet ages 7-9
Monday 5:15-6:00 Gymnastics ages 7-9
Monday 6:20-7:05 Ballet ages 10-12
Monday 4:15-5:00 Gymnastics ages 3-4
Monday 6:15-7:00 Gymnastics ages 5-6
Tuesday 6:45-7:30 Hip Hop ages 10+
Tuesday 5:15-6:00 Gymnastics ages 3-4
Tuesday 6:15-7:00 Gymnastics ages 5-6
Tuesday 7:15-8:00 Gymnastics ages 7-9
Wednesday 4:15-5:00 Gymnastics ages 3-4
Wednesday 5:15-6:00 Gymnastics ages 7-9
Wednesday 6:15-7:00 Gymnastics ages 10+
Thursday 6:00-6:45 Jazz ages 10+
Thursday 5:00-5:45

Gymnastics ages 5-6

Thursday 6:45-7:30

Acrobatics ages 10+

Thursday 5:30-6:15 Hip Hop ages 5-6
Thursday 6:20-7:05 Hip Hop ages 7-9
Thursday 7:10-7:55 Recreational Musical Theatre 7+
Saturday 9:00-9:30 Creative Dance 1
Saturday 9:40-10:10 Creative Dance 2
Saturday 10:15-11:00 Jazz ages 5-6
Saturday 11:15-12:00 Acrobatics ages 7-9
Saturday 12:05-12:50 Jazz ages 7-9
Saturday 1:00-1:45 Tap ages 7-9
Saturday 10:00-10:45 Tap ages 5-6
Saturday 11:00-11:45 Jazz ages 10-12


Check one:
American Express

Please Note:

  • If you are paying with a credit card, please call 613-623-5938 with your card details after you complete and submit this form.

  • If you are paying by e-transfer, please send your payment to


Payment due


Term 1 September 9th to November 1st -
** No classes on Thursday September 30th and Thanksgiving weekend: Saturday October 9th & Monday October 11th
Term 2 November 2nd to December 20th
Term 3 January 10th to February 28th
Term 4 March 1st to Year End Recital on May 7th


By submitting this registration you are acknowledging that you have read the ASD activity agenda, rules and regulations and that you and your family will abide by them.

  • Registration form must be accompanied with term payment to hold your spot in the program.
  • The following footwear is required: Jazz: Black Jazz slipper, leather or canvas, Tap: Black (no staccato taps), Ballet - Boy: Black full sole Ballet or Jazz slipper, Ballet - Girls: Pink full sole Ballet slipper, Musical Theatre or Hip Hop: Clean, indoor running shoe, Acrobatics, Gymnastics or Lyrical: Bare feet. Bring your shoes with you, Shoes worn outside can't be worn in the studio.
  • The following clothing is required: Ballet, Jazz, Lyrical or Tap: Bodysuit, any colour or style or yoga wear. Dance shorts/skirts may be worn, Acrobatics or Gymnastics: Bodysuit, yoga wear. Boys shorts & t-shirt, Musical Theatre or Hip Hop: Yoga wear, shorts, t-shirt or track pants.
  • All hair must be pulled back off the face and neck.
  • You agree to allow ASD to email you information regarding classes & events.
  • ASD may use your child’s picture or video for advertising.
  • Parents must reference the child's full name in all correspondence
  • Due to COVID restrictions, family members are restricted from entering the ASD building.
  • No refunds after registration, no stop payments of credit cards once classes have begun.
  • If classes are forced to continue via Google Classroom, no refunds will be issued.
  • It is the dancers/parents responsibility to call the dance phone to see if classes are cancelled due to weather, holidays etc. Call 613-623-5938
  • NSF fee is $25.00. This applies to all declined credit cards. After 2 NSF's or declined credit cards, full payment in cash or money order.
  • You must inform the office with new CC info if the expiry date changes mid season, $25.00 late fee charge will be applied if your payment is late.
  • Choreography and costumes are selected by the Teacher & Director only. Parents are responsible for all costume alterations.
  • The recital is not optional, all dancers will participate, tickets are required to watch your child in the recital.
  • Respect for the facility, instructors & fellow dancers is expected, removal from the program will result without refund.
  • Dancers will be removed for habitual lateness, poor attendance or habitual infractions of the dress code. No refunds will be issued.



Understands that the Activities, like all recreational activities, involve risk of serious injury, including permanent disability or death, and severe social and economic losses which might result from participant action, inaction, negligence of others, rules of play, or the condition of the premises or any equipment used thereon.

Understands that there may be other risks not known or reasonably foreseeable at this time and that such risks shall be assumed by the undersigned.

Understands that the chance of an injury occurring can be reduced by carefully following instructions at all times while engaged in the Activities.


Understands that as a Participant in the Activities, I am assuming the risks associated with the Activities.


Fully understands that the Activities for which I have given permission to the Participant to be involved in may involve personal risk, dangers, and hazards which all participants are required to assume including but not limited to some risk of personal injury caused by physical activity or other participants. Understanding this, I hereby accept on behalf of the Participant all risks, dangers, and hazards as well as the possibility of personal injury or other loss resulting from the Participant’s participation in the Activities.


Agrees to indemnify and save harmless the Arnprior School of Dance, its employees, officials, agents, directors, and volunteers, from any and all liability for injury, death, property damage or any other loss sustained by the Participant as a result of participation in the Activities to any cause whatsoever; including negligence, breach of contract, or breach of any statutory or other duty of care; and

Agrees to indemnify and save harmless the landlord and the owners of 394 Russett Drive, Arnprior, for the same.


Individuals who have traveled outside of Canada within the previous 14 days or who are sick or who have been in contact with someone who is suspected of having Covid-19 must not use the facilities or attend classes. This access may be withdrawn at any time based on health agency recommendations. In response to efforts to contain the spread of COVID-19 Coronavirus, I am aware that I am using the facilities at my own risk. If at anytime I travel outside of Canada or have been in contact with anyone who is suspected of having COVID-19, I agree to have my family self isolate for 14 days and will not attend activities at Arnprior School of Dance. Arnprior School of Dance has put in place preventative measures to reduce the spread of COVID-19; however, Arnprior School of Dance cannot guarantee that you or your child(ren) will not become infected with COVID-19. Attending any public spaces increases your risk and your child(ren)’s risk of contracting COVID-19.

I acknowledge that I have read the above and agree to the waiver of liability, all rules, regulations, terms & conditions.

Registration is only complete once full payment is received.  Your child's spot cannot be held without full payment.


Studio Address:
394 Russett Drive, Arnprior K7S 3G8
Mailing Address:
204 Campbell Drive, Arnprior Ontario K7S 3G8