Registration

Step 1 of 5 - Service contract

Service contract
Service contract between:

Station Cirque Inc
12 Provost, La Prairie, Qc, J5R6M9
514 594-9410 www.stationcirque.com
info@stationcirque.com

And:
(write the name of the parent, tutor or person over 18 years old who signs and pays for this contract)
Last Name*
First Name*
Hereafter designated as “the client”.

Participant
It is mandatory to complete all the fields below. All the information supplied will be kept confidential.
Last Name of participant *
First Name of participant *
Assurance-maladie (RAMQ) number*
Age of participant*
If the participant is less than 18 years old, the participant’s parents or legal guardian will be required to sign the present contract.
- Less than 18 years old
- More than 18 years old
Birthdate*
Last name of parent or legal guardian*
First name of parent or legal guardian*
Address*
Address City State / Province Postal code
Phone*
Email*
Does the participant have any allergies, medical conditions or injuries?*
- Yes
- No
List of allergies, medical conditions and injuries of the participant*

Choice of classes
4 CLASSES OF 60 MIN 2-9-16-30 MAY PRICE for 4 CLASSES, GROUP: 129.99$ PLUS TAXES. 4 PRIVATE CLASSES 1 PERSON: 259.99$ PLUS TAXES. 4 SEMI-PRIVATE CLASSES 2 PERSONS: 159.99$ PER PERSON PLUS TAXES. FREE PRACTICE : 28$ PER PERSON PLUS TAXES. 1 PRIVATE CLASS FOR 1 PERSON 67$ PLUS TAXES. 1 SEMI-PRIVATE CLASS FOR 2 PERSONS: 37$ PLUS TAXES PER PERSON.
Choice of classes and fees*
Winter 2026 Select your class below. PLEASE WAIT FOR YOUR BILL BEFORE PAYING. taxes are NOT included. Payment is via Interac transfer.

Legal notices and regulations
Mention required by the Québec Consumer Protection Act (sections 195 and 46):

The client may terminate this contract at any time by sending a written notice by email to Cirque Station at info@stationcirque.com. The contract shall be terminated, without further formalities, once the notice has been sent.

If the client terminates this contract before Station Cirque has begun to perform its primary obligation, the client has no charge or penalty to pay. If the client cancels the contract after Station Cirque has begun to perform its principal obligation, the client only has to pay:

a) The price of the services provided to him, calculated pro rata to the courses offered (whether attended by the participant or not) plus
b) The lesser of these 2 amounts: $ 50 or an amount not exceeding 10% of the price of the services that were not provided to the person.

Waiver and rules of Station Cirque:
- A registration is valid only if payment is made at the same time as registration.
- A minimum number of participants is required to start an activity.
- There is no rescheduling or reimbursement in case of absence to one or more activities.
- Prices are subject to change without notice.
- This contract is personal and it is non-transferable. It cannot be given or transferred to another person.
- The practice of circus arts, like all sports and athletic activities, may cause injury, worsen pre-existing medical conditions, or cause death. If you have any doubt that the participant can perform such activities, please consult a doctor before registering.
- The client authorizes Station Cirque to take the necessary measures in case of emergency for a participant.
- Station Cirque has insurance to cover its civil liability, however the school discharges itself of any liability towards the participant in case of purely accidental injuries.
- Station Cirque discharges itself from any liability to the participant’s property in the event of loss of theft.
- Station Cirque discharges itself from any liability to the participant outside the hours of the activity to which the participant is registered on this contract.
- The safety instructions must be strictly observed at all times by the participants and their accompanying persons if applicable.
- In the interest of public health, participants with symptoms of contagious diseases such as (but not limited to) covid-19, cold, flu, gastrointestinal diseases, are not admitted in class.
- A good personal hygiene is required; hands and feet especially must be clean at all times.
- No food or drink other than water in a closed container is accepted.
- A courteous, friendly and respectful attitude is required. No offensive language, discrimination, verbal or physical abuse or inappropriate gesture will be tolerated.
- The client agrees that the image of the participant and their accompanying persons if applicable (photo, video), is used on the website, social networks and the printed or electronic material of Station Cirque, as means to illustrate and promote the teaching activities of the school.
- The client certifies that the information provided on this form is true and complete.
- The client acknowledges having received a copy of this contract, either electronically or on paper.
- The client acknowledges having read and understood all the clauses appearing in this contract and declares himself satisfied with them.
Acceptance of contract and regulations*
The client acknowledges having read and understood all the clauses appearing in this contract and declares himself satisfied with them. The client has noted the dates of classes INCLUDING THE DATES AT WHICH THERE ARE NO CLASSES.
- I agree
Covid-19*
- I agree to strictly comply with the public health directives in effect at the time of classes.
Covid-19*
- I understand that zero risk does not exist in the prevention of covid-19 and that Station Cirque will not be held responsible for any possible contamination.
Promotion emails
The client accepts to receive promotional emails from Station Cirque.
- I agree

Payment
Payment is made by interac transfer; an invoice will be sent to you within 24 hours of receiving your registration. The amount must be paid in full before the start of classes.
IMPORTANT: THE EMAIL ADDRESS STATED ON THE REGISTRATION AGREEMENT MUST BE THE SAME USED FOR THE INTERAC TRANSFER.
Name
This field is for validation purposes and should be left unchanged.

Registration

Step 1 of 5 - Service contract

Service contract

Participant

Choice of classes

Legal notices and regulations

Payment

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