2008/2009 Registration Form

Registration fee: $15 single / $25 family
Click here for class description page
* (required field)

Student #1 *First Name: *Last Name:

*Classes signing up for:





*Birthdate (mm/dd/yyyy): / / *Grade:

Student #2 First Name: Last Name:

Classes signing up for:





Birthdate (mm/dd/yyyy): / / Grade:

Student #3 First Name: Last Name:

Classes signing up for:





Birthdate (mm/dd/yyyy): / / Grade:

*Parent/Guardian Name: (Type n/a if signing up for Adult class)

*Address:
*City: *State: *Zip:

*Home phone:

*Cell/ or emergency phone:


Email Address:


School attending in 2008/2009:


How did you hear about us?: Newspaper Website Yellow Pages Referral Other

Previous Dance Training?: Yes No
If Yes, Where? How Many Years?

Optional Comments:


* By selecting "I Agree," you verify that all information is correct to the best of your knowledge, you are 18 or over and either are the student or the parent/legal guardian of the student(s) that you are registering. You also acknowledge that falsifying any information on this form may lead to student dismissal without any refund.