Fall 2022
DANCE MACHINES DANCE STUDIO, INC.

*** REGISTRATION FEE - $60.00 PER STUDENT ***
 

DATE________

STUDENTS NAME_______________________________________________________

AGE_________  DATE OF BIRTH_____________  SCHOOL GRADE______________

PARENTS NAME_______________________________________ DL #_____________

ADDRESS_________________________________ CITY____________ ZIP_________

CELL PHONE ___________________________________________________________

EMAIL_________________________________________________________________

EMERGENCY CONTACT NAME __________________________________________

EMERGENCY NUMBER _________________________________________________

CLASS REGISTRATION

COMBINATION ___________ (Tap and Ballet) AGES 18 mos - 2

COMBINATION ___________ (Tap and Ballet) AGES 3 - 4

COMBINATION ___________ (Tap and Ballet) AGES 5 - 6

COMBINATION ___________ (Tap and Ballet) AGES 7 and up

JAZZ________ HIP HOP________  TECHNIQUE________  DRILL TEAM________

MONTHLY TUITION

*****$15 LATE FEE APPLIES AFTER THE 10^TH OF THE MONTH*****

1ST CLASS (PER CHILD)..............................................................$70.00                

ADDITIONAL CLASS (PER CHILD)...........................................$40.00

Please sign the Policies and Waiver form!