DANCE TOGETHER FOR 2 OR 3 YEAR OLDS REGISTRATION FORM 2021-2022
42-16 28th Avenue 2nd Floor, Astoria, NY 11103 718.278.1567
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Registration fee and tuition payment must accompany this registration form.
Today's Date:
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Are you a New Student or Returning Student?
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Date of Birth: *
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Age: *
Student's First and Last Name: *
Parent/Guardian Name: *
Mailing Address: *
Street and Apartment #, City, State, Zip Code
Home Phone #: *
Cell Phone #: *
Email Address Required: *
Previous Experience? If yes, please list:
How did you hear about Astoria Dance Centre:
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Please list here any medical conditions or disabilities we should know about:
Dance Together Session Calendar - Sessions ll & lll
Saturdays - Session ll Begins November 6th and Ends December 18th - CLOSED - AT CAPACITY - NO LONGER ACCEPTING REGISTRATIONS FOR SESSION ll

Saturdays - Session lll Begins February 5th and End March 19th

Session lll & lV = TBA
Select your day and time for our Dance Together Class - Session lll *
Non-refundable registration fee $15.00 per student. Class Tuition Fee: $120.00
Required
You will receive a phone call from ADC to pay your non-refundable registration fee and the class tuition fee within 72 hours of registration.
Please read and check the box below: *
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Electronic Signature or Parent/Guardian if student is under 18: *
*SCHEDULE IS SUBJECT TO CHANGE OR CANCELLATION PENDING ENROLLMENT.
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