REGISTRATION

Tuesday nights in the month of July on the 8th, 15th, 22nd and 29th. Cost is $65.00 for the Month!

Student Name(Required)

DOB

Mom's Email(Required)

Dad's Email(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mom Cell Phone

Dad Cell Phone

Emergency Contact(Required)

Emergency Phone(Required)

Allergies or Medical

Tuesday Evening Class Options

5:00pm-5:45pm. 3 & 4 year olds (Ballet and tap)

5:45pm-6:45 pm. 5 - 7 year olds (Ballet and Hip Hop)

6:45pm-7:45pm. 7 - 10 year olds ( Ballet and Jazz)

4735863319