Parent's name *

First Name

Last Name

Phone *

(###)

###

####

Student's name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Student's Birthdate

MM

DD

YYYY

Classes*

Strength & Stretch / Wed 2:15 -3:15 pm / Amy

Beg Pointe / Wed 3:15 -4:15 pm / Amy

Intermediate & Advanced — Pointe / Wed 4:15 -5:15 pm / Emily

Intermediate & Advanced — Jazz / Wed 5:15 -6:00 pm / Emily

Intermediate & Advanced — Ballet / Wed 6:00 -7:00 pm / Emily

Intermediate & Advanced — Modern/ Contemporary (*alternating weeks) / Wed 7:00 -7:45 pm / Emily

Intermediate & Advanced — Hip Hop / Wed 7:00 -7:45 pm / Zander

Intermediate & Advanced — Tap / Wed 7:45 -8:30 pm / Emily