STUDENT REGISTRATION FORM
Please fill in the fields correctly. For multiple participants, please submit the registration forms individually. You will be contacted shortly after submitting the form.
Email address *
Date
MM
/
DD
/
YYYY
Full Name *
Your answer
Gender *
NRIC/Passport/FIN
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Are you older than 18 years old? *
If 'No' for the above, please indicate Parent/Guardian's Full Name
Your answer
Relationship
Salutation
Parent Contact Number
Your answer
Shoe size Type
Shoe Size
Your answer
Nationality
Your answer
Mobile Number *
Your answer
Home Number
Your answer
Email *
Your answer
Which type of lesson? *
For Introductory Trial Class, select date and time
Day preferred (only for Small Group or Open Group)
Time preferred (only for Small Group and Open Group)
Payment method preferred *
Indemnity and Release
By taking the lessons, I am aware of the inherent risks due to unforeseen accidents which may result in serious injury, disability and death. I agree to undertake all the risks associated with the lessons and understand that they do not guarantee safety during the lessons and the lessons assume no responsibility for patrons' safety or property. While I understand that every care has been taken by the instructor, I confirm that I will not hold the instructor or company responsible in any way liable for my injury, disability, death or any loss or damage whatsoever arising from any cause in connection with the lesson or my participant therein.
I confirm that I have read and agree with the indemnity and release *
Required
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