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Enrollment

Student Information

Your Name (required)

Nickname

Date of Birth (mm/dd/yyy)

Current Address

Street (include APT # as well)

City

State

Zip

Home Phone

Cell Phone

Your Email (required)

What is their favorite dance Style?

What would they like to achieve in dance:

What is their personality (Shy, Outgoing, Silly, Coming out of their shell, etc)?

Emergency Contact (local)

Name

Relationship

Home Phone

Cell Phone

Work Phone

Additional Info

How did you hear about us:

Your Message

“The essence of all art is to have pleasure in giving pleasure.”

— Mikhail Baryshnikov