Children Dance Registration Form

Please fill in ALL the fields

Student Name*:

Date of Birth*:

Address*:

Parent/Guardian Name #1*: Phone*:

Parent/Guardian Name #2*: Phone*:

Email*:

Any medical health disorders, preventing the student from participating classes without discomfort YesNo

Class selection*:

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1) Please check for Spam/Promotions folder for confirmation email
2) Click "Submit"

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