Apply To Dance At Supreme
Students Name
*
First Name
Last Name
Students Date of Birth
-
Day
-
Month
Year
Date
Parent/ Guardian Name
*
First Name
Last Name
Parents Phone Number
*
-
First Name
Phone Number
E-mail
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you have any medical conditions or injuries we should know about?
*
Do you have any previous dance experience?
Which classes are you interested in ?
Jazz
Contemporary
Street Dance
RAD Ballet
Pointe
Acro
Competition Squad
Please verify that you are human
*
Declaration
*
I accept the Supreme Dance terms and conditions
Submit
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