FALL 2017
DANCE MACHINES DANCE STUDIO, INC.

*** REGISTRATION FEE - $40.00 PER STUDENT ***
 

DATE________ STUDENTS NAME_________________________________________

AGE_________  DATE OF BIRTH_____________  SCHOOL GRADE______________

PARENTS NAME_______________________________________ DL #____________

ADDRESS_________________________________ CITY____________ ZIP________

HOME PHONE ______________________ CELL PHONE ______________________

EMAIL_______________________________________________________________

EMERGENCY NAME & #_________________________________________________

CLASS REGISTRATION

COMBINATION ________ (tap and ballet) AGES 2-7      JAZZ________   TAP________

BALLET/POINTE________    LYRICAL_________   HIP HOP_________ 

CHEER/GYMNASTICS_______   STRENGTH/CONDITIONING_________

MONTHLY TUITION

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

1ST CLASS (PER CHILD).....$60.00                 ADDITIONAL CLASS.....$40.00

 

Please sign/initial the Policies and Waiver form!