LICSB Summer Dance Registration
Monday - Friday 8:00AM - 2:30PM

Thank you for registering your child for LICSB Summer Dance! We are looking forward to a fun filled, enriching experience for all! Please fill out the registration form below. Registration will be completed when payment is made.

Checks can be made out and mailed to:

44-02 23rd Street
Studio 216
LIC, NY. 11101

Name *
Your answer
Birthdate *
Your answer
Parent's name *
Your answer
Email *
Your answer
Phone *
Your answer
Week Selection *
Siblings attending? Please list name and birthdate
Your answer
Emergency contact *
In the event a parent can not be reached, please list an additional contact name and phone number:
Your answer
Allergies / Medical Alerts *
Daily snack will be provided. Please list any special requirements your child may have.
Your answer
Where did you hear about us? *
Payment method *
Thank you!
You will receive a email confirmation when your registration is completed. See you this summer!
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