Registration Information

Student’s Name:______________________________

Guardian’s Name:_____________________________

Address:____________________________________

___________________________________________

Home Phone:________________________________

Work Phone:________________________________

Cell Phone:_________________________________

Emai Address:______________________________

Emergency Phone:___________________________

Emergency Contact Person:____________________

Classes you would like to register for:

__________________________________________

__________________________________________

__________________________________________

__________________________________________

Years of Dance Training:______________________

Level of Dance: Circle one

Level I: Beginner

Level II: Advanced Beginner, Intermediate

Level III: Intermediate, Advanced

Registration:

Registration: $30.00

Remember, former students receive a five-dollar deduction on registration except Late Registration.

Register Early to Avoid Disappointment.