Summer Registration

Each student must have a separate registration form (even siblings). Please fill out completely. Remember your spot will only be held in the class of your choice with tuition fees paid.

• Student Information:

Student Name:

Student Age: Student DOB:

Previous Experience:


Special Needs (if any):

• Parent/Guardian & Contact Info:

Parent/Guardian Name:

Complete Mailing Address:



Day Phone:

Evening Phone:

Mobile Phone:

E-Mail Address:

• Emergency Contact Info:

Please note: The information provided in this section must be someone other than parent/guardian listed above. Studio 4 Dance will always attempt to contact a parent/guardian first in case of an emergency. This section's purpose is in the event a parent/guardian cannot be reached.

Emergency Contact Name:

Relationship to Student:

Emergency Contact Phone:

 Monday 5:00-5:45 Family Yoga $45 ind / $65 family

 Tues 5:30-7:00 Ballet/Pre-Pointe $80

 Tues 7:00-8:30 Ballet/Pointe $80

 Wednesday 4:00-5:00 Ballet/Tap (3-4 yrs) $60

 Wednesday 5:00-6:30 Tap/Ballet/Jazz (5-7 yrs) $80

 Wednesday 6:30-8:00 Tap/Ballet/Jazz (8-10 yrs) $80

Please enter the code below so we know you are human!