I AM Dance 2020/2021 Registration Form

Student Registration Form

Fill out the form carefully for registration. Classes begin Monday, Sept. 14th
Parent/Guardian

First Name Last Name
Student's Name

First Name Middle Name Last Name
Birth Date

Month Day Year
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail
Phone Number

Area Code Phone Number
Emergency Contact (other then name listed above)

First Name Last Name
Emergency Contact Phone Number

Area Code Phone Number
Classes (no more than 7 students per class)
Please list and Allergies or Medical Information:

My Products

Registration Fee $ 25.00

Registration Fee secures dancer's spot. This fee is non-refundable and is not included in monthly tuition.

Total $ 0.00

Student Registration Form