Registration Form

Vedanza Dance Studio

Kids Classes Registration Form
How did you hear about us?*
Other:
Student Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent / Guardian Name*

First NameLast Name
Parent E-mail*
example@example.com
Phone Number*
I want to sign up for:

Two Week Trial ($19)Monthly Classes (Starts at $65)
Classes

Latin Kids (Monday 4pm)Latin Teens (Monday 5pm)Ballet 1 (Tuesday 4pm)Mini Jazz (Tuesday 4pm)Mini Ballet (Tuesday 5pm)Jazz 1 (Tuesday 5pm)Ballet 1 (Wednesday 4pm)Lyrical Ballet 1/2 (Wednesday 5pm)
Additional Comments
Should be Empty:

Vedanza Dance Studio