| |
|
| | |
| | Studio 34 Dance Academy Registration Form - Please Print | |
| | *One Per Dancer | |
| |
| |
| | | |
| | _________________________________
Student Name | _________________________________
Age | _________________________________
Grade (as of 9/10)
| |
| | | | | |
|
| | | | |
| | _________________________________
Parent/Guardian Name | _________________________________
Phone Number | _________________________________
Cell Number | |
| | | | | |
|
| | | | |
| | _________________________________
Address | _________________________________
City / State | _________________________________
Zip Code
| |
| | | | | |
|
| __________________________________________________________
Email Address | |
| | |
|
| | | |
| | Class: | Day: | Time: | |
|
| | | | |
| | 1._______________________________ | _________________________________ | _________________________________ |
|
| | | | | |
| |
2._______________________________ | _________________________________ | _________________________________ | |
| | | | |
|
| | 3._______________________________ | _________________________________ | _________________________________ | |
| | | |
| |
| | 4._______________________________ | _________________________________ | _________________________________ | |
| | |
| | |
| | 5._______________________________ | _________________________________ | _________________________________ | |
|
| | | | |
| | 6._______________________________ | _________________________________ | _________________________________ |
|
| | | | | |
| |
7._______________________________ | _________________________________ | _________________________________ | |
| | | | |
|
| | 8._______________________________ | _________________________________ | _________________________________ | |
| | | |
| |
| | 9._______________________________ | _________________________________ | _________________________________ | |
| | |
| | |
| | 10.______________________________ | _________________________________ | _________________________________ | |
|
| | | | |
| | | | | |
| | _________________________________
Total Classes per week
| _________________________________
Total Monthly Tuition | | |
| |
| | | |
| | | | | |
| | _________________________________
Parent/Guardian Signature |
_________________________________
Date | | |
| | |
|
