KIDS & TEEN DANCE CLASS
REGISTRATION FORM
Name:______________________________________________________
Address:____________________________________________________
City:____________________State:__________________Zip:__________
Home Phone:(____)________________
Grade:_____ Age:_____ Birthday:_____/_____/_____
Check all that apply:
_____Mini-KIDS Class ------------------------------ $80
_____KIDS Class ------------------------------ $265
_____KIDS Birthday Party ---------------------$135
_____TEEN Class ~~~~~~~~~~~~~~~~$265
TEEN Summer CAMP~~~~~~~~~~~$550
_____ Please mail us the Teen Summer Camp Registration Forms.
CLASS DAY Circle: MON TUES WED THURS
CLASS Time: ________
(Please include and mail in any discount certificates you may have with this registration form.)
Parent #1 Name____________________________
Parent #1 Work Phone:(____)___________Cell Phone:(____)___________
Parent #1 E-mail____________________________
Address (if different from above):_______________________________________
Parent #2 Name____________________________
Parent #2 Work Phone:(____)___________Cell Phone:(____)___________
Parent #2 E-mail____________________________
Address (if different from above):_______________________________________
How did you learn about Two Left Feet?____________________________
Is there any additional information we should know about your child?
_____________________________________________________________
