Student Registration Form
Summer Class Option(s)
Tuesday Ages 2-3 Combo Class
Tuesday Ages 4-6 Combo Class
Tuesday Ages 7-9 Combo Class
Tuesday Ages 18 & Up Adult Dance Fitness
Wednesday Ages 7 - 12 Ballet Strength & Conditioning Class
Wednesday Ages 13 - 18 Ballet Strength & Conditioning Class
Wednesday Ages 18 & Up Adult Dance Fitness
Thursday Ages 10-12 Combo Class
Thursday Ages 13-18 Combo Class
Name
First Name
Last Name
Age
Date Of Birth
Anything we may need to know about the student
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Emergency Contact Information
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Signature
Continue
Continue
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