Student Registration Form 学生注册表


* Name in English
英文姓名 : 		Name in Chinese
中文姓名 : 		Class day
上课时间 : 		SAT 周六SUN 周日
* Age 年龄 : Date of Birth
出生年月 : 		Address and Postal Code
地址和邮编 :
Parent’s Name
(if child is under 18 years of age)
家长姓名 : 		Phone # (cell) 手机:

Home Phone 家庭电话 :

Yes / No MGWPA Member
(if child is under 18 years of age)
本人或父母 (学员十八岁以下)
是/否 长城艺术团会员
* E-mail
电子邮件 : 		I prefer receive school notice by
学校信息接受方式 :
邮件 Email
手机 Cell phone
电话 Home phone
Registered Class
注册班级 : 		Class Time
上课时间 :

Waiver:

Great Wall Dance Academy of Canada (GWDAC) and Manitoba Great Wall Performing Arts Inc. (MGWPA) shall not be responsible for any injuries or damage caused to the student as a result of his or her participation in any of its activities. GWDAC and MGWPA reserves the right to use any of students’ photos, film, video, and other material for publication in newspapers, magazines, websites, advertisements, posters, brochures, slides and other promotional materials.

By checking the accept checkbox, I acknowledge that I have read the above statement, understand and accept all the terms.

 Accept