Fall 09 Registration

Student Name:
Student Age:
Student DOB:
Parent Gaurdian Name:
Complete Mailing Address:
Day Phone:
Evening Phone:
Mobile Phone:
E Mail Address:
Emergency Contact:
Emergency Contact Phone:
Previous Experience:
Specials Needs:

Please let us know what type of class(es) you are interested in and how much experience you’ve had in that area so we can find just the right class for you this fall!

Class Type Years Experience
3-4 yrs ~ Pre-Ballet/Tap None

1+
5-7 yrs ~ Tap/Ballet/Jazz None

1-2
5-7 yrs ~ Tap/Ballet None

1-2
5-7 yrs ~ Ballet/Jazz None

1-2
8-10 yrs ~ Tap/Ballet/Jazz None

1-2

3+
8-10 yrs ~ Tap/Ballet None

1-2

3+
8-10 yrs ~ Ballet/Jazz None

1-2

3+
11+ yrs ~ Tap/Ballet/Jazz None

1-2

3+
11+ yrs ~ Tap/Ballet None

1-2

3+
11+ yrs ~ Ballet/Jazz None

1-2

3+
Family Yoga ~ Ages 3-Adult
(How many family members will be attending?)

 None

1-2

3+
Adult Tap, Ballet or Jazz (enter preference for style)
I would prefer:

 None

1-2

3+