Studio One Dance School

Fall   2010/11 Dance

Registration/Tuition Form
Make checks payable to Studio One Dance School
We now accept Credit cards 
 6680 Odana Rd  Madison WI  53719    608-833-8885

Pre-Registration Fee $20.00

First name________________________________________________________________

Last Name___________________ _Age_______current student _____ New student_____

Address_________________________________City/zip___________________________ 

Parent mother name_________________________Father___________-Guardian________

Contact #________________Work______________Cell #__________Emergency#_________

Previous dance experience______________________________________________________

Classes______________  Times______________ Day of week___________# weeks______

______________________Times___________________________________________________

______________________Times_______________________________________________ 

_____________________ Times________________________________________Total_____

Registration /Tuition due in full before starting classes.  No exceptions., No refunds.

Make checks payable to Studio One Dance School  Mail in, or in person.

I here by release Studio One Dance School from all Liability for any personal injury,illness or property damage occurring on school premises.
I have read the registration form information. I am responsible for tuition payments.  I certify that my child /ern is in good health.  I herby give permission to participate in all dance activities.   Parent/Guardian signature _

   _______________________________________ date ____________2010