Course Registration Form

Registration Form

Fill out the form carefully for registration
Student Name*

First NameLast Name
Class Date You Plan To Attend *

MonthDayYear
Date
Courses*
Birth Date*

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Mobile Number*
Company
Additional Comments
My Products
prevnext( X )
CarribbeanFIT
$15.00



StilettoFIT
$15.00



Children Ballet/Tap Combo
$20.00



Mommy & Me
$15.00



Miscellaneous
$100.00 Quantity



Total

$0.00
Should be Empty: