Dancer Name *

First Name

Last Name

Ages 8-11; 10:00 am -11:00 am

Drop-ins are welcome and should be paid in studio with cash, check or cc at time of class.

March 4, 11, 18, 25, April 1, 8 - $60

Ages 12+; 10:00 am- 11:30 am

Drop-ins are welcome and should be paid in studio at time of class with cash, check or cc.

March 4, 11, 18, 25, April 1, 8, 15, 29 - $96

Dancer Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Dancer Phone #

(if applicable)

(###)

###

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Parent/Guardian *

First Name

Last Name

Parent/Guardian

First Name

Last Name

Parent/Guardian Phone

(###)

###

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Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

(###)

###

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