School Registration

To register for the Brush-a-mania Student contest, click here.

All information entered is displayed on our website except email addresses.

School Name (required)

Address (required)

City (required)

Province (required)

Postal Code (required)

Phone (required)

School Contact Salutation (required)

School Contact First Name (required)

School Contact Last Name (required)

School Email (required)

Confirm Email (required)

Name of Dentist Requested (optional)

Please indicate the number of classes and students that you would like to participate in Brush-a-mania:

Total Number of Classes (required)

Total Number of Students (required)

For more information, contact Jennifer Boyd at: jennifer@brushamania.ca