Program Enrolment Form

Member's Name *

First Name

Last Name

Member's Date of Birth *

MM

DD

YYYY

Parent/Guardians Name *

First Name

Last Name

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Program/s

Which program/s are you enrolling in?

Dance - Tippy Toe Co. classes

Dance Camp

TheraDance

Exercise and Sport - Ninja Warrior

Yoga - Yogacise

TheraYoga

Media consent *

As the parent/guardian of the member listed above, I give/do not give Active Eight permission to use professional images and video for promotional purposes. This may include; media articles and editorials, A8 website, print material (flyers, posters, etc), social media posts and grant applications.

Do give

Do not give

Subscribe *

Join the A8 emailing list to receive updates, newsletters and other news and events.

I do want to subscribe

I do not want to subscribe