September/October 2023 Mondays Blues Dance “Zero to Hero” Course Registration Form CourseBlues Dance "Zero to Hero" Mondays September 11, 18, October 2, 16, 23, 30InformationDate(s): Mondays September 11, 18, October 2, 16, 23, 306.0 hrs of classes in total over six weeksTime: 9:00pm to 10:00pmVenue: Hurndale Room, Eastminster United ChurchAddress: 310 Danforth Ave, Toronto, ON M4K 1N6* Enter the church from the doors on Jackman Avenue.As a courtesy to your teacher(s) and fellow students, please arrive a few minutes early so that you are ready to start right on time.Your First Name *Your Last Name *Your Email Address *A receipt and confirmation will be sent to this email address.Are you a full-time student?No, I am not a full-time student ($90)Yes, I am a full-time student ($80)If yes, please show student ID upon arrivalWill you be a follower or leader? *Please indicate your intended roleI will be followerI will be a leaderThis helps us manage lead-follow balance in our lessonsI would like to register and pay for another personPerson's First Name *Person's Last Name *Is this person a full-time student?No, they are not a full-time student ($90)Yes, they are a full-time student ($80)If yes, please show student ID upon arrivalWill this person be a follower or leader? *Please indicate this person's intended roleThey will be a followerThey will be a leaderThis helps us manage lead-follow balance in our lessonsBilling InformationBilling Name *The name associated with the form of payment. (e.g. name on the credit card)Billing Address *Apartment, suite, etcCity *State/Province *ZIP / Postal Code *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemen Arab Rep.Yemen DemocraticZambiaZimbabweSubtotalHSTCountTotalPayment DetailsNumber of attendees: {calculation-4}Subtotal: ${calculation-2}HST: ${calculation-3}Your TOTAL is: ${calculation-1}Credit / Debit Card **Swing Toronto partners with Stripe for payment processingPay Now