VICKI JO DANCE STUDIO REGISTRATION - 2017

 

STUDENT__________________________________ AGE_______BIRTHDATE___________________

GRADE_____(FALL 2017)

 

PLEASE CIRCLE CLASSES TO BE TAKEN:

 

BALLET - AVAILABLE FOR AGES 3 & UP                                      CLASS SCHEDULES WILL BE MAILED

 

TAP - AVAILABLE FOR AGES 5 & UP                                           AT THE END OF AUGUST, CALL FOR

 

JAZZ - AVAILABLE FOR AGES 7 & UP                                         TENTATIVE SCHEDULE. (937-866-5151)

 

HIP HOP- AVAILABLE FOR AGES 8 & UP 

ACROBAT - AVAILABLE FOR AGES 3 & UP

 

HAWAIIAN - AVAILABLE FOR AGES 9 & UP

MUSICAL THEATER - 8 & UP

PARENT (OR PERSON RESPONSIBLE)__________________________________________________

 

ADDRESS___________________________________CITY_____________________ZIP__________

EMAIL ADDRESS______________________________________________________

 

HOME PHONE___________________WORK PHONE_________________CELL___________________

 

REGISTRATION FEE OF $12.00. IF PREVIOUS STUDENT REGISTERS BEFORE RECITAL, FEE IS $6.00. CLASS FEES ARE DUE EACH MONTH FOR THAT MONTH REGARDLESS OF ATTENDANCE. RECEIVE A FREE LESSON IF A NEW STUDENT GIVES US YOUR NAME AT REGISTRATION. A LATE FEE OF $8.00 WILL BE CHARGED FOR PAYMENTS NOT MADE IN THE MONTH IT IS DUE. RETURNED CHECK FEE WILL BE $14.00.

 

PARENT SIGNATURE_________________________________________________

 

Where did you hear about the dance studio? _______________________________________