*** The Old Schoolhouse...Dance Memories ***
STUDENT REGISTRATION NAME__________________________________
AGE(unless adult)________
PARENTS NAME (unless adult)____________________ PHONE___________________ ADDRESS__________________________________ ZIP______________ E-Mail Address (optional)___________________________________
Date of Birth (optional)_____________________________________
EXTRA CLASSES DESIRED:______Tap _______Pointe (age 12 and over)
Which class do you plan to attend?...Day________ and Time________
_____Boy _____Girl
Yes, I would be interested in a Theater Movement Class _________
Dance Wear Needed?
SIZES Ballet Shoes ____ Tap Shoe ____ Leotard ____ Tights ____
CREDIT - USED/TURNED IN ITEMS. _____________
STUDENT REGISTRATION NAME__________________________________
AGE(unless adult)________
PARENTS NAME (unless adult)____________________ PHONE___________________ ADDRESS__________________________________ ZIP______________ E-Mail Address (optional)___________________________________
Date of Birth (optional)_____________________________________
EXTRA CLASSES DESIRED:______Tap _______Pointe (age 12 and over)
Which class do you plan to attend?...Day________ and Time________
_____Boy _____Girl
Yes, I would be interested in a Theater Movement Class _________
Dance Wear Needed?
SIZES Ballet Shoes ____ Tap Shoe ____ Leotard ____ Tights ____
CREDIT - USED/TURNED IN ITEMS. _____________