Dance Class Registration Form

Name*

First NameLast Name

Age*

Gender

MaleFemale

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

example@example.com

Phone Number*

Email*

example@example.com

Select the class you are registering for

Relationship*

Parent/guardian

First and last NameContact #

My Products

ONE CLASS A WEEK 4 TIMES A MONTH

One class a week ballet hip-hop yoga Pilates

$56.00 Quantity
Item subtotal:$0.00

2 CLASSES A WEEK 8 classes a month

$112.00 Quantity
Item subtotal:$0.00

3 classes a week 9 classes a month

$156.00 Quantity
Item subtotal:$0.00

ONE CLASS

$20.00 Quantity
Item subtotal:$0.00

GIFT Certificate

Give The gift of dance good for 8 30 minute classes

$100.00

FREE TRIAL CLASS FIRST MONDAYS ONLY

Drop in on a free trial class every first Monday

$ Free

Enter coupon

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Parent/guardian Signature

Silver Lakes Dance Studio