Registration
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Student Name *
Date Of Birth *
MM
/
DD
/
YYYY
Address (Street, City, Zip) *
Parent/Guardian Name *
Parent/Guardian Cell # *
Email Address: *
Emergency Contact (Name, Phone) *
Allergies/Medical Conditions
Years Of Previous Dance Training *
Check the classes you are registering for
Ballet & Tap Combo (ages 2-5)
Jr.Acro Jazz (ages 4-6)
Ballet (ages 6-7)
Tap (ages 6-7)
Pre-Jazz (ages 6-7)
Hippity Hop(ages 6-7)
Lyrical Ballet (ages 8 - up)
Tap (ages 8 - up)
Jazz (ages 8 - up)
Hip Hop (ages 8 - up)
Acro Jazz (ages 8 - up)
Musical Theater (ages 9 -up)
Conditioning (ages 9 -up)
Solo/Duo/Trio
Payment required upon submission
Payment Instructions
$25 paid to:

Venmo: @April-Martindale-2
or
PayPal: @centerstagellc
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