Summer Dance Class Registration

Dancer's Name*

First Last

Date Of Registration*

Class Sign Up

* JUNE 2-WEEK MINI DANCE WORKSHOP JUNE 5th-15th

*Dancer is allowed to miss up to one week of dance class due to vacation. Make-ups can be done before or after in another dance class. Please check with your teacher.

Monday/ Wednesday Please Choose all Classes you are registering for.

(6-10 years) Mon/Wed 5:15-6:00| Beg Tap
(3-5 years) Mon/Wed 5:15-6:00| Beg Tap
(7-10 years) Mon/Wed 6:00-6:45| Ballet
(3-5 years) Mon/Wed 6:00-6:45| Creative/Ballet
(8-Adults) Mon/Wed 6:45-7:40| Irish
(Teen-Adult) Mon/Wed 6:45/7:40| Tap
(Teen/Adult) Mon/Wed 7:45-8:40| Tap

Tuesday/Thursday Please Choose all classes you are registering for.

(4-6 years) Tues/Thurs 5:15-6:00| Creative/Ballet
(7-10 Years) Tues/Thurs 5:15-6:00| Int. Tap
(3-5 years) Tues/Thurs 6:00-6:45| Jazz/Hip-Hop
(6-10 years) Tues/Thurs 6:00-6:45| Jazz/Hip-Hop
(Teen/Adult) Tues/Thurs 6:45-7:40| Beg Lyrical/Jazz/Hip Hop
(Teen/Adult) Tues/Thurs 6:45-7:40| Ballet
(Teen/Adult) Tues/Thurs 7:45-8:40| Int. Lyrical/Jazz/Hip Hop
(Teen/Adult) Tues/Thurs 7:45-8:40| Ballet

* JUNE 4-DAY DANCE WORKSHOP JUNE 19th-22nd

*Dancer is allowed to miss up to two days of dance class due to vacation. Make-ups can be done before or after in another dance class. Please check with your teacher.

Please choose all classes you are registering for.

(3-5 years) 4:30-5:15 | Creative/Ballet
(6-10 years) 4:30-5:15 | Ballet
(11- Teen/Adult) 6:00-6:55 | Beg. Ballet
(8-Adult) 7:00-7:55 | Int/Adv Ballet
(8-Adult) 8:00-8:55| Lyrical/Jazz/Hip Hop
(8-Adult) 9:00-9:55| Tap

* JULY 3-WEEK DANCE CAMP JULY 15th - AUG 1st

*Dancer is allowed to miss up to one week of dance class due to vacation. Make-ups can be done before or after in another dance class. Please check with your teacher.

Monday/Wednesday Please choose all classes you are registering for.

(3-5 years) Mon/Wed 5:15-6:00 | Tap 1/2
(6-10 Years) Mon/Wed 5:15-6:00 | Tap 1/2
(4-6 years) Mon/Wed 6:00-6:45 | Creative Ballet 1/2
(6-10 Years) Mon/Wed 6:00-6:45 | Jazz/Hip Hop 1/2
(Teen/Adult) Mon/Wed 6:45-7:40 | Tap 1/2
(Teen-Adult) Mon/Wed 7:45-8:40 | Dance Exercise

Tuesday/Thursday Please choose all classes that you are registering for.

(3-5 years) Tues/Thurs 5:15-6:00 | Creative/Ballet 1/2
(6-10 Years) Tues/Thurs 5:15-6:00 | Jazz/Hip Hop/Lyrical 1/2
(3-5 years) Tues/Thurs 6:00-6:45 | Jazz/Hip-Hop 1/2
(6-10 years) Tues/Thurs 6:00-6:45 | Ballet 1/2
(Teen-Adult) Tues/Thurs 6:45-7:40 | Ballet 1/2
(Teen/Adult) Tues/Thurs 6:45-7:40 | Jazz/Hip Hop/Lyrical 1/2
(Teen-Adult) Tues/Thurs 7:45-8:40 | Jazz/Hip-Hop/Lyrical 1/2
(Teen-Adult) Tues/Thurs 7:45-8:40 | Ballet 3/4

Dancer Information

Sex

Female
Male

Address*

Street Address City State ZIP Code

Home Phone*

(xxx) xxx - xxxx

Cell Phone

(xxx) xxx - xxxx

Email

Age*

Birth Date*

Grade

School

Have you studied dance before?*

Yes
No

Describe what type of dance and how many years.

How did you hear about us?*

Name of person who referred you

Fill this out only if you heard about us from a friend

Father's Information

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Workplace

Occupation

Work Phone

(xxx) xxx - xxxx

Home Phone

(xxx) xxx - xxxx

Cell Phone

(xxx) xxx - xxxx

Email

Mother's Information

Name

First Last

Address

Street Address City State ZIP Code

Workplace

Occupation

Work Phone

(xxx) xxx - xxxx

Home Phone

(xxx) xxx - xxxx

Cell Phone

(xxx) xxx - xxxx

Email

Person Responsible for Payments

Please check who is responsible for payments*

Father
Mother
Either, Father or Mother
Other (if this option is selected please fill out section below)

Name

Address

Street Address City State ZIP Code

Relation

Home Phone

Cell Phone

Work Phone

Emergency Contact Information

In case of emergency, who can we contact other than the parents/guardians listed above.

Name*

First Last

Phone

Relation*

Address*

Street Address City State ZIP Code

Phone Number*

(xxx) xxx - xxxx

Cell Phone

(xxx) xxx - xxxx

Workplace

(xxx) xxx - xxxx

Work Phone

(xxx) xxx - xxxx

Form Of Payment*

Paypal
Cash in Office (no registration is completed until paid for)

To pay online click here.

Email

This field is for validation purposes and should be left unchanged.

Class Sign Up

* JUNE 2-WEEK MINI DANCE WORKSHOP JUNE 5th-15th

* JUNE 4-DAY DANCE WORKSHOP JUNE 19th-22nd

* JULY 3-WEEK DANCE CAMP JULY 15th - AUG 1st

**Dancer Information**

**Father's Information**

Mother's Information

**Person Responsible for Payments**

**Emergency Contact Information**

Dancer Information

Father's Information

Person Responsible for Payments

Emergency Contact Information