-- STUDENT REGISTRATION --
Select 1 or more workshops
1 class--$30
2 classes--$56
3 classes--$84
4 classes--$105
Kicks, Turns, Leaps
Stretch, Flex, Tone
Lyrical Workshop
Jazz Hop
Princess Day Workshop
Parent First Name:
Parent Last Name:
Student First Name:
Student Last Name:
Student Age:
Address:
City:
State:
Zip:
Primary Phone Number:
(Phone Number)
Secondary Phone Number:
Email:
(E-mail)
Emergency Contact Name:
Emergency Contact Number:
Health Insurance Provider:
Health Insurance Policy #:
Health Insurance Primary Name:
NOTE:
You can select and register for
more than one class
