Dancer Registration

Dancer Registration

Registration form and participation fee ($50 for members / $80 for non-members) is due by October 31, 2016.

* Required

Group Levels are as follows:

• BEGINNER ~ age 4 (by September 2016) through 2nd grade
• JUNIOR ~ 3rd grade through 6th grade
• SENIOR ~ 7th grade through 12th grade
• ALUMNI ~ Past participants of the dance program

First Name *

Last Name *

School grade * grade attending in the Fall 2016

Please indicate dance level: *

• BEGINNER (age 4 by September 30, 2016 through 2nd grade)

• JUNIOR (4th through 6th grade)

• SENIOR (7th through 12th grade)

• YOUNG ADULT (past participants of the program - no fee)

Parent name(s) first and last

Mailing Address *

Home Phone

Parent Cell Phone

Parent Email

Dancer Cell Phone (if applicable)

Dancer Email (if applicable)

Please list any allergies or medical condition instructors should be aware of: