Dance Evolution Inc
2019/2020 Dance Season
Student Name *
Your answer
Parent Name *
Your answer
Email *
Your answer
Mailing Address
Your answer
Student Date of Birth *
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DD
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YYYY
Current Age of Student *
Your answer
Prior dance experience? *
Your answer
Best Contact Number *
Your answer
Emergency Contact Information *
Your answer
Does your student have any physical limitations or allergies? *
Your answer
Which classes are you registering for? Day & Time? *
Your answer
Contract Information
I understand that by signing this form I am responsible for all tuition and other fees for this student. By signing, I am saying that my student is physically healthy enough to begin this program. I further understand that if I am signing the student up for the September-June term (or the remaining portion thereof), or for the summer term (July & August). I understand that if my student wishes to discontinue their classes before the end of the term, I need to give the office a 2 WEEK WRITTEN NOTICE.
I understand & agree with the contract information *
Required
I would like to set up automatic payments? *
We will be contacting you shortly about class availability
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