Student Name
Date Of Birth
Age
Address
Parent/Guardian Name
E-mail Address
Contact Telephone
Cell Phone
Emergancy Contact Name
Emergency Telephone
Emergency Cell Phone
Dance Class Registration
I would Like To Register For ...........
If This Class Is Full My 2nd Choice Would Be.....
I would Like To Register For Another Class.......
If This Class Is Full My 2nd Choice Would Be.....
I would Like To Register For Another Class.......
If This Class Is Full My 2nd Choice Would Be.....
Where Did You Hear About Our Studio?????
A $25 Registration Fee Is Required Per Family.
Fee Is Paid Once Per Season Upon Registration.
Please Mail A $25 Check To:
Creative Steps Dance Studio
56 Westminster Ave
Watertown, Ma 02472
City
Zip Code
Sibling Name if enrolling also
Date Of Birth of sibling
Age of sibling
