Prime Time Dance Factory - Dancer Registration Form

Parent/Guardian Information
Parent/Guardian Name*

First NameLast Name
Yes
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Emergency Contact (If Parent/Guardian cannot be reached)*
Relationship to Dancer*
Phone Number*

Area CodePhone Number

Additional Information
YesNo
If yes, please explain:
Fundraiser HelperRecital/Showcase HelperParade HelperFood/Snack/Drink ProviderRecital/Showcase HelperNot to Sure
Please let us know which group/area you are interested in assisting with.
Anything additional we need to know?

Confirmation
Dancer Expectations: Come to every practice Be on time Bring a positive attitute Wear appropriate dance attire Be respectful to dancers/teachers/parents Communicate with Teacher
Signature of Student(s)*

Clear
Date Signed*

MonthDayYear
Date
Parents Expectations: Pay dance fees on time Support your dancer Communicate with teacher Be on time
Parent/guardian Signature*

Clear
Date Signed*

MonthDayYear
Date
Registration Fees:
First Class is Free !!!
prevnext( X )
Dancer 1$40.00

Size

Tuition $125.00
Tuition is a monthly rate

Total $0.00
Should be Empty: