CLASS APPLICATION | zeekersdanz

Zeekers Workshop/Drop-In Application Form

First name

Last name

Gender

Email

Phone

Birthday

Month

Day

Year

Municipality

Age

Please enter your current age

Please select the group level you are applying for

Kids Class (Ages 7-12) 5 - 6pm

Open Class 6 - 7pm

Please select the program level you are applying for

Workshop $140 (5 Classes)

Drop-In $30

(All above rates tax included)

Please upload the transfer slip

Your spot will be officially confirmed once both the form and payment are received.

Complete the e-Transfer payment to zeekersdanz@gmail.com

Dance Experience

None

1–2 years

3–5 years

6+ years

How many years of dance experience do you have?

Emergency Contact

Emergency Contact Phone

Emergency Contact Relation

Medical Information - Do you have any medical conditions, injuries, or allergies we should be aware of?

No, I do not have any medical conditions, injuries, or allergies.

Yes — please specify:

Medical Information — Please specify

Consent & Agreement

I confirm that all information provided is accurate.

I understand that Zeekers Danz reserves the right of final admission.

I agree to follow the training program rules, code of conduct, and safety guidelines.

(For minors) I, the parent/guardian, give consent for my child to participate in this program.

Click here to view the full [Zeekers Danz Participation Terms & Wavier]Your signature below confirms that you have read, understood, and agreed to the above terms and waiver.

Signature

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Perfect for beginners, dance lovers, and anyone aspiring to perform on stage!

Zeekers Workshop/Drop-In Application Form

Perfect for beginners,
dance lovers, and anyone aspiring to perform on stage!