Request edit access
Fall Registration for Dance & Tumbling
Fall 2019 Registration for Dance & Tumbling Classes
202 South Iowa Avenue * Washington, IA 52353
Contact us at (319) 461-2390 or
Registration Fee will be billed to your account. $10 if registration is received by April 30th, $20 after April 30th.
Student's Name (First & Last)
Student's Date of Birth
Student's Grade in Fall of 2020
Parent's Name(s) (First & Last)
Mailing Address (Street Address & City)
Phone Number (Mom)
Phone Number (Dad)
Classes to register for:
Jazz (must be registered for ballet)
Clog (must be registered for tap)
Hip Hop (must be registered for ballet & jazz)
Wee Dance (2 year olds)
Creative Dance (3 year olds)
Preschool Ballet & Tap (4 year olds)
Day of the week you prefer if multiple choices were offered for your classes on your information sheet:
Please note questions etc here:
Tuition is a yearly charge which you may make in one payment, two payments or nine monthly payments. If you choose nine monthly payments that payment is due the first lesson of each month and payments made after the 15th of the month will be assessed a $15.00 late charge. There is a $25.00 service charge on all returned checks. One written month notice with tuition is required to withdraw registration. In consideration of the acceptance of this application for registration, I waive and release any and all rights and claims for damages which I may have against Stairway to the Stars for any and all damages which may be sustained and suffered traveling to, participating in or returning from the school. The school does not provide medical insurance. NO REFUNDS ARE GIVEN. Please type your name below:
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service