Thillai Fine Arts - Student Registration Form

Thillai Fine Arts Bharatanayam Classes at Parsippany Main Library Registration Form

www.thillaifinearts.org 848.200.3030 info@thillaifinearts.org
Thillai Fine arts will be conducting Indian Classical Bhratanatyam classes at Parsippanny Main Libary (449 Halsey Rd, Parsippany, NJ 07054)

Every Monday - Starting Februay 3, 2020

Beginners Class: 6.30 pm to 7.30 pm

Advanced Class: 7.30 pm to 8.30 pm

Calender provided by Parsippany Public Library (on registration completion)
Student Name:*

First NameLast Name
Student Age:*
BeginnerAdvanced
Junior - Small (Ages 4-6 years: $30)Junior - Medium (Ages 7-10 years: $30)Junior - Large (Ages 11 - 15 years: $30)Adult Size (Ages 16 and above: $35)
Medical Conditions(if any):
Mother's Name (if participant under 18) or Emergency Contact Info:*

First NameLast Name
Students's cell Phone Number (Mobile):

Area CodePhone Number
Mother's Primary Phone Number (Mobile):*

Area CodePhone Number
Mother's E-mail:*
Please ensure accuracy. Registration confirmation will be sent to this email.
Father's Name (if participant under 18) or Emergency Contact Info:*

First NameLast Name
Father's Primary Phone Number (Mobile):*

Area CodePhone Number
Father's E-mail:*
Please ensure accuracy. Registration confirmation will be sent to this email.
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Emergency Contact Name:*

First NameLast Name
Emergency Contact Number (Mobile):*

Area CodePhone Number
Square Cash AppZelle AppCredit Card (3% Fees Apply)
Guidelines:
1. Students should wear the Thillai uniform to attend classes
2. Students should be present on time at start of each class
3. Plan to bring your own water
4. Fees are due at on the first day of each month (1st).
5. Classes will be conducted on the dates and time provided by the Parsippany Main library.
I agree and accept guidelines above (Signature)

First NameLast Name
Should be Empty:

Thillai Fine Arts Bharatanayam Classes at Parsippany Main Library Registration Form