MasXpressions Dance Company
MasXDance Company SCHEDULE
Junior Company
Ages 6-11
Mondays
5:00PM-7:00PM
Senior Company
Ages 12-16
Wednesdays
5:00PM-7:00PM
All Members
Saturday
5:00PM-7:00PM
Student Information
Name
First Name
Last Name
Age
*
Gender
Male
Female
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Write something about yourself
Parent/Guardian Information
For minors (below 18 years of age)
Parent/Guardian Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Relationship
Miscellaneous
How do you learn about our dance company?
Facebook
Twitter
Instagram
YouTube
Search Engine
Online Ads
Referral
Other
Shirt Size
S
M
L
XL
XXL
Do you want to add enroll more students?
Yes
No
Additional students
Payment & Confirmation
Payment Method
Cash
Credit Card
Check
PayPal
Other
Signature of Student
Date Signed
-
Month
-
Day
Year
Date
Parent/guardian Name
First Name
Last Name
Parent/guardian Signature
Date Signed
-
Month
-
Day
Year
Date
Submit
Submit
Print Form
Should be Empty: