Students Name:
Parents/Guardians:
Address:
City:
State:
Zip:
Home Phone:
Mother's Work Phone:
Father's Work Phone:
Cell Phone:
E-Mail:
Cell Phone Belonging to:
Emergency Contact:
Emergency Contact Phone:
Child's Birth Date:
Age:
School
Grade
Previous years of dance:
Name of Studio (if other than Dance Dreams):
(For scheduling purposes)What is the earliest time the student can come to class?
What day(s) is the student available to dance?
Does the student have any health concerns we should know about (Allergies, Asthma, Diabetes, Etc.)
If someone other than yourself is paying for the child's lessons then please provide:
Name:
Phone #:
PLEASE CHECK CLASSES TO BE TAKEN:
Mousercise (Beg. Ages 3-4) Creative Movement /Tumbling:
Kinderdance (Ages 4-5) Ballet, Tap, Jazz, Gym Combination:
Gradeschool (Ages 6-7) Ballet, Tap, Jazz Combination:
The following classes are offered to ages 8 and up:
Ballet (Required to take Jazz & Lyrical):
Tap:
Lyrical (offered to ages 8 and up, Ballet class required):
Competition Team (Ages 5 & Up) By audition only:
Other (special sessions):
Website Photo Permission
Please DO NOT use my childs photo on the website:
You may use my child's photo only on the website:
You may use my childs photo and first name on the website:
I have read and accept the studio policies form and fully agree to it's terms and conditions.
