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Registration Form

Student First & Last Name*

Parent(s) Name*

Birthday

Month

Day

Year

Address*

Email*

Phone

Emergency Contact Phone Number*

Youth T-Shirt Size

X-Small

Small

Medium

Large

Adult T-Shirt Size

X-Small

Small

Medium

Large

Does Student Have Dance Experience?*

Types of Dance Training

Dance Class Fees:*

$60.00- Non-Refundable Registration Fee for Kids

$80.00 Single Class

$80.00 Private Class Studio

$160.00 Combo Class

$20.00 on-Refundable Registration Fee for Adults

Studio Rental

No Child Will Not Allowed To Take Class If Fees Have Not Been Paid

Waiver of Liability

Non- Refundable Registration Fee*

$60

$20

Please select which apply:

Adult Fee- $20, Child Fee- $60

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