Studio 34 Dance Academy - Summer Registration Form



*Studio 34 Dance Academy Summer Registration Form - Please Print*
Session 1 JULY 18 - JULY 21 / Session 2 JULY 25 - JULY 28


_________________________________ Student Name	_________________________________ Age	_________________________________ Grade (as of 9/11)


_________________________________ Parent/Guardian Name	_________________________________ Phone Number	_________________________________ Cell Number


_________________________________ Address	_________________________________ City / State	_________________________________ Zip Code

__________________________________________________________ Email Address

Class:	Day:	Time:	Session 1 or 2
1.__________________________	____________________________	____________________________	____________________________

2.__________________________	____________________________	____________________________	____________________________

3.__________________________	____________________________	____________________________	____________________________

4.__________________________	____________________________	____________________________	____________________________

5.__________________________	____________________________	____________________________	____________________________

6.__________________________	____________________________	____________________________	____________________________

7.__________________________	____________________________	____________________________	____________________________

8.__________________________	____________________________	____________________________	____________________________


____________________________	____________________________
Total Classes per week	Total Amount of Sessions

______________________________
Total Summer Session Amount Due


___________________________________		__________________________
Parent/Guardian Signature		Date


*One Per Dancer