Danceworks Brooklyn Registeration

Please be reminded, your child is not offically registred until your first month & registration fee are paid. Cash, Check, Credit Card or venmo to @fallon-white are acceptable for class payments. Registration fees are cash only.
September 2023 - June 2024 Enrollment

Register before September 1st to receive FREE registration!
Student Information:*

First NameLast NameBirthdate Age
Parent / Emergency Contact 1*

First NameLast NameEmailContact Number
Parent / Emergency Contact 2

First NameLast NameEmailContact Number
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Has the student had any medical history and / or allergies that we should be aware of? *

Privacy Please

Please DO NOT feature my child's image on your social media sites
I understand the terms above & take full financial responsibility for the term of September 2023 - June 2024. *

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Credit Card Information