fill out form below and return to the dance studio                             





First months payment is due with form.



Dancer's Name__________________________________________________


Age ____________________ Grade______________

Phone # _________________ cell # _________________________

Address (include zip) _____________________________________________

email ________________________________________

Any allergies or special conditions that you wish to disclose?             



           

Parent/guardian Signature___________________________________date_______

Amy's Dance Dynamics will not be held responsible or liable for any injuries that may occur


Registration Form 2008/2009 Dance Season

     Class day and time :