NEW STUDENT- SPECIFIC CLASS / TRIAL CLASS INTEREST
Diversity Dance Studio
PARENT NAME
*
First Name
Last Name
PARENT EMAIL
*
example@example.com
PHONE NUMBER
*
Please enter a valid phone number.
DANCER NAME
First Name
Last Name
WHERE YOU REFERRED BY A FRIEND / CURRENT DIVERSITY DANCE MEMBER?
ARE YOU TRYING ONE OF THE POP UP OR TRIAL CLASSES?
Musical Theatre (Rebel Vibe) Class 9/15 (6:30-8pm)
NEW! Hip Hop (ages 7-10) 9/15 (5:45-6:30pm)
Tuesdays Musical Theatre (ages 14-19) (7:30-9:30pm)
Other
DANCER IS INTERESTED IN :
COMPANY / COMPETITION
JAZZ
LYRICAL
BALLET
TAP
MUSICAL THEATRE
STRENGTH TRAINING
MOM / ADULT CLASS
Other
DANCER IS INTERESTED IN PRIVATE DANCE LESSONS
YES
NO
YEARS OF PREVIOUS TRAINING
DANCER BIRTHDAY
*
DANCER PHONE NUMBER
DATE OF VISIT / INQUIRY
-
Month
-
Day
Year
Date
NOTES/ DANCE EXPERIENCE/ INTERESTS. ETC
Submit
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