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Registration and Questionnaire

Name of Student_____________________
Parent_____________________________
Address____________________________
City_______________________________
Zip Code ___________________________
Birthdate___________________________
Email:  ____________________________
Cell Phone:  _________________________

 

Can you attend class during the week?  ______________
What is the earliest you can come during the week?______
Can you attend class on Saturday?  _________________

If you attended Chez Dance last year, what class did you take?
__________________________________________
__________________________________________
__________________________________________

What form of dance do you wish to study?
____Creative I
____Creative II
____1/2 Ballet & 1/2 Jazz
____1/2 Tap & 1/2 Jazz
____1/2, 1/2 & 1/2
____45 Ballet & 45 Jazz
____45 Jazz & 45 Tap
____Ballet
____Jazz
____Tap
____Street Jazz
____Modern

To reserve a spot in class please return this form with a $30.00
registration fee and 1st month tuition payment.  Our fax
number if 856-875-4481.

Any questions, please call the studio at 856-875-4475.

 

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