New Customer Registration Form

THRILL DANCERS REGISTRATION FORM
DANCER'S NAME*

First NameLast Name
Dancer's Birthday

MonthDayYear
Date
PARENT / GUARDIAN NAME*

First NameLast Name
ADDRESS*

Street Number

Street Address

City Province

Postal Code
CELL PHONE NUMBER*
EMAIL*
example@example.com
ALTERNATE / EMERGENCY CONTACT *

Full Name Phone Number
I AM INTERESTED IN*

RECREATIONAL - ONE CLASSRECREATIONAL - MULTI CLASSPRE COMPETITIVECOMPETITIVEDAY / DANCE CAMPSUMMER RECREATIONAL - ONE CLASSSUMMER RECREATIONAL - MULTI - CLASSSUMMER COMPETITIVE PROGRAM
OTHER
DANCE STYLES

JAZZBALLETTAPHIP HOPLYRICAL / CONTEMPORARYACRO
ANY HEALTH ISSUES WE SHOULD KNOW ABOUT:
NOTES:
Should be Empty:

THRILL DANCERS REGISTRATION FORM