Registration


Event:
Start Date/Time: End Date/Time:
Room:
* - denotes required fields
Contact Information:
First Name:* Last Name: *
Type:
Home Phone: * Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact
Information:
 
 
 
Questions/Options:
How did you learn about this event? School Flyer, Home Mailer, Email, Internet, Friend, Sign
Please choose your first class: Tap, Group Piano, Art, Theatre Games
Please choose your second class: Hip Hop, Group Strings, Art, Theatre Improv
Please choose your third class: Irish Dance, Strummed Instruments, Art, Mini Play
 
Additional Information:
 
 
Other Questions/Comments: