Studio A Dance Center Registration Form

Studio A Dance Center Registration Form
Student's Name*
First NameLast Name
Birthdate
MonthDayYear
Date
Student's Name (sibling #2)
First NameLast Name
Date
MonthDayYear
Date
Student's Name (sibling #3)
First NameLast Name
Date
MonthDayYear
Date
Parent's Name*
First NameLast Name
Parent's Name*
First NameLast Name
Email*
example@example.com
Address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Phone Number*
Area CodePhone Number
Classes interested in
BalletTapJazzAcroLyrical (ages 7 and up)Hip Hop (ages 6 and up)Creative movement (18 months-2 years)Pre-School (ages 3-5)Adult Tap/Jazz
Please list any allergies or medical conditions your child has that we need to be aware of*
Should be Empty: