Fall Registration Form
Note: Please be sure to give a working email address, ALL studio information and notices will come ONLY through email. Please check email for your child’s schedule and studio updates.

PAYMENTS DUE AT TIME OF REGISTRATION:

Registration Fee: $35.00 for single student, $55.00 for family
Costume Deposit: $35.00 for EACH CLASS
Recital Fee: $15.00 for single student, $25.00 for family

These payments can be brought to the studio during summer office hours - Lewiston Studio: TBA,
GI Studio: TBA or mailed to Lewiston Dance Inc. PO BOX 424 GI, NY 14072

First Name
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Last Name
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Age
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Date Of Birth
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Grade student will attend in the fall
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Street Address
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City
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Zip Code
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Phone
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Email Address
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Medical Conditions, Allergies or Disabilities
Your answer
Please list anything you would like us to know about your child
Type Of Dance
Required
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