Dance Registration Form

Wild Rose Dance Studio Registration

Please fill out the forms below and have them handed in and the class payed for, by a maximum of one week before your class starts.
When you fill out this form, you are signing up for:

Session 3 (February 28th - April 27th 2023) Groups A, B, & C

Fee $100.00
Dancer

First NameLast Name
Date of birth
Month/ Day/Year
Age
Gender
Parent or guardian

First NameLast Name
E-mail
ex: myname@example.com
Phone Number

PrimarySecondary
Form of payment
Permission to share photos/videos taken in classes or recitals on my Facebook page
If you have any questions please contact Leilani Oakes at: wildrosedancestudio@gmail.com
Should be Empty:

Wild Rose Dance Studio Registration