Jitterbugs Swingapore - Registration

2 Handy Road #B1-08 The Cathay Singapore 229233 | T.65.6887.0383 | F.65.6887.0538

FULL CLASS SCHEDULE

PARTNER DANCES
• Lindy Hop
• Salsa On1 / On2
• Casino / Rueda
• Bachata
• Merengue
• Street Cha Cha Cha
• Tango

NON-PARTNER
DANCES
• Ballet
• Contemporary
• Jazz / Lyrical Jazz / Broadway Jazz
• Hip Hop / Hip Hop Teens
• Tap
• Body Movement

HOLISTIC
• Pilates

GALS ONLY!
• Belly Dancing
• Grrl Power
• Ladies Salsa Styling
• Pole Dance
• Exotic Dance

TOTS & KIDS
• Dance Babes
• Ballet Kids
• Hip Hop Kids
• Street Jazz for Kids
• CSTD Tap Kids
• CSTD Jazz for Kids

Site Design:
GadgetGal

Use this form to register your interest in the upcoming course. Please include an accurate telephone number; inaccurate and insufficient information provided by you will delay the registration process. After you have submitted this form, we will contact you for payment and to finalize your registration.

Please note that full payment is required to confirm a place in a course . So, once we receive your registration for the workshop and a spot is available, we will hold it for 3 days. In the meantime, please process the e-mail payment request which you will receive.

If you are registering for all other courses, please click here.

POLE TRIAL CLASS REGISTRATION

First Name
Last Name
Gender	Gal
IC/PP/FIN No
Birth Date	[YYYY]

Address

Postal Code

Day Phone
Mobile Phone
Email Address

GENTRE / LEVEL

Sun 20-Sep-2009, 2 pm
Sun 13-Dec-2009, 3:30 pm

Fees:

Please note that the cost reflected here is the per class rate. You will be advised of the final cost when you make payment.

S$18 - Pole Trial Class only (Member)
(Member # )

S$27 - Pole Trial Class only (NonMember)

Payment Mode:

Bank Transfer PayPal Cheque, by mail

Make payment at the studio personally

AGREEMENT AND WAIVER
In consideration of the dance lessons provided to the student under this agreement by Jitterbugs Swingapore, and in recognition of the physically strenuous nature of dancing, The student hereby knowingly, freely, and voluntarily waives any right or cause of action of any kind whatsoever arising as a result of such activities from which any liability may or could accrue to Jitterbugs Swingapore or its agents.

The student understands that the obligation to pay all fees described in the brochure / application is unconditional. No fees, paid or outstanding, is refunded in whole or in part in the event of any absence, withdrawal, or dismissal of the student. The student agrees to pay all incidental expenses as may be incurred by the student which include, but are not limited to, costumes, dancewear, footwear and similar items.

Please note that any changes to course registration(s) after payment is subject to the sole discretion of Jitterbugs Swingapore and to an administrative charge. The student further agrees to pay any reasonable costs associated with Jitterbugs Swingapore's effort to collect funds due it under the terms of this agreement for late payment.

The student hereby gives Jitterbugs Swingapore permission to photograph and/or video record the student for use in brochures, websites, and any other advertising media. The student understands that said photographs and video will be copyrighted in Jitterbugs Swingapore's name.

I agree to the Agreement and Waiver Yes No

Full Name
Today's Date

8-Week Courses
Fee: $120 per course
(Members) /
$160 per course
(NonMembers)

Pole-licious / Pole-xercise
8-Week Courses
$144 per course
(Members) /
$216 per course
(NonMembers)
* Students have to be age 18 yeaers and above.

Membership fee:
$50 per annum.
($25 per annum for students and NSF

•	For maximum dance-ability, some classes require early registration and advance payment of the cost of the entire course.
•	No replacement class or refund will be made for any class missed.
•	A S$20 administrative fee will be applied per change per person for cancellation or any changes made with more than 7 days notice prior to the date of commencement.
•	A S$40 administrative fee will be applied per change per person for cancellation or any changes made with less than 7 days notice prior to the date of commencement.
•	The course fee is forfeit if no notice is given of non-attendance.