STUDENT NAME: _____________________________________________ PHONE: _______________________
PARENT'S NAME: _____________________________________________E-MAIL _______________________
Address________________________________________________ _________________ ______________
city zip
CELL PHONE NUMBER: _______________________________ ____________________________________
Mom dad
D.O.B _____________________ AGE __________ EXPERIENCE: _________________________________
ANY MEDICAL/PHYSICAL CONDITION? __________________________________________________________
CLASS REGISTERED FOR DAY TIME TUITION/MO.
___________________________ ____________ ___________ _____________
___________________________ ____________ ___________ _____________
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STUDENT #2 NAME: _____________________________________________ PHONE: ____________________
Address________________________________________________ _________________ ______________
city zip
CELL PHONE NUMBER: _______________________________ ____________________________________
Mom dad
D.O.B _____________________ AGE __________ EXPERIENCE: _________________________________
ANY MEDICAL/PHYSICAL CONDITION? __________________________________________________________
CLASS REGISTERED FOR DAY TIME TUITION/MO.
___________________________ ____________ ___________ _____________
___________________________ ____________ ___________ _____________
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Office use only
TODAY'S DATE:____________ ANNUAL REGISTRATION FEE: $35 / PERSON ____________
$75 / FAMILY ____________
TUITION: (3 mo. 5% off, 6 mo. 10% off, full yr. 15% off) ____________
REHEARSAL FEE: $15 / STUDENT ____________
TOTAL DUE TODAY: ____________
