Registration

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Dance Intensive is for students 11 years old and up, Monday-Friday 1:00-3:30PM. Students should wear leotard, tights, and have ballet, tap and jazz shoes. Please bring water bottle and small peanut free snack if desired. Fee $100.00 ($5 discount if paid by June 15). Check in will be in the B220 hallway and you will be directed to the correct dance room. Credit card on file or entered at time of registration will be charged at the time of registration. Full refund if notified by email prior to June 1. 1/2 refund if notified by email by June 15. No refund for any later date.

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Family Information

	First Name:*	Last Name: *
	Type*
	Home Phone:*	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info*

Students entered below will be added to your family's account

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)
	Student Email:
	School:*	Grade Level:*
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Photo Release? (Y/N):*
	Video Release? (Y/N):*
	Have you had lessons before?:*
	If yes, where? If no, N/A:*
	If yes, how long? If no, N/A:*

Additional Information:

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