Segal Academy - Registration Form



2017 - 18 Academy Form

Student First Name : Student Last Name : Date of Birth : Current Age : School : Allergies :
Parent/Guardian Information
Parent #1 Name: Parent #2 Name: Address (number, street) Address (city, province, postal code) Home Phone : Primary contact number (please indicate which parent/guardian) Other contact phone number (please indicate which parent/guardian) Primary parent/guardian email (all Academy emails will go to this address)
Emergency Contact other than parent/guardian
Name : Phone Number : Relation : How did you hear of the Segal Academy?


Explain if you selected 'other' : By checking this box, you are giving the Segal Centre permission to use photographs of your child(ren) for promotional purposes to promote the Segal Centre and the Academy. Ask a question :

Courses :














Course Info:
YAYA
Grades 2-7
Wednesdays, 5-7pm
$330/session (2 sessions), $50 costume fee

Broadway Stars
Grades 2-8
$450/session (2 sessions) + $50 costume fee

Broadway Stars 1
Introductory course
Tuesdays, 5-7 p.m.

Broadway Stars 2
Introductory course
Wednesdays, 5-7 p.m.

Broadway Stars 3
Advanced course (Auditions required)
Mondays, 5-7 p.m.

Broadway & Beyond
Grades 7-11 (Auditions required)
January 2018 – April 2018 (starts January 11)
Thursdays, 6-8 p.m. & Sunday, 10-1 p.m.
$950/session (1 session), $50 one time costume fee, plus tax for students 14+

Premiere PED Day Camps
November 24 and December 11 (BJEC Ped Day)
$45/day

Intermission Spring Break Camp
March 5-9
$250/week- must attend all 5 days

Act One Passover Camp
April 3,4
$45/day

Centre Stage Summer Camp Session 1
July 2-13
$250/week, must attend 2 week session

Centre Stage Summer Camp Session 2
July 30 - August 10
$250/week, must attend 2 week session


**Please note: For the after-school courses: If you pay for both sessions in full before October 16, 2017, you will receive a 10% discount off the total amount. If you pay for any of the camps before December 22, 2017 you will receive a 10% discount off the total amount.