Burns Dance Studio Registration Form
For classes beginning October 7th!
Customer Details:
Parent Name
*
First Name
Last Name
Child's Name
*
First Name
Last Name
Child's birthdate
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
2nd Child's Name
First Name
Last Name
2nd Child's birthdate
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
How did you hear about us?
*
Please Select
Facebook
Instagram
Google
Friend
Other
Please Specify
*
Class choices (visit www.burnsdancestudio.com for options)
Ages 3-5 STARS tap/ballet/acro, Wednesdays 5:30-6:15PM
Ages 5-7 Intro to ballet, Wednesday 4:45-5:30PM
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Registration Fee
$9.99
$
9.99
Quantity
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