DANCE TOGETHER For 2’s and 3’s REGISTRATION FORM 2020-2021
42-16 28th Avenue 2nd Floor, Astoria, NY 11103 718.278.1567
Registration fee and tuition payment must accompany this registration form.
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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:
Saturday Dance Together Session at 9:15 AM *
Non-refundable registration fee $15.00 per student for a maximum of $30.00. Class Tuition Fee: $162.00
You will receive an email with your PayPal invoice to pay your non-refundable registration fee and class tuition fee.
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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