Please Print and send with registration fee for classes Thank you.

Studio One Dance School
2012 Registration form
6680 Odana Rd Madison WI 53719
608-833-8885
Student Name_____________________________________ Fall Grade ____ Age____________
Mother Name_________________________________________________________________
Father Name_________________________________________________________________
Telephone # ________________________________________________________________
Mobile #1______________Mobile #2__________
Email_____________________________________/__________________________
Previous Dance ____________________________________________________________
Information_________________________________________________________________
Classes/Days____________________________________________________________________
_____________________________________________________________________________
__________________________________________________________________________
Type of Payment_______________________
Registration Fee $25.00 ____________________Date___________Total_______________
Discount/______/_______________________ Total______________
Please send in all information and form before class begins.
Thank You
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No refunds,. Credit only. 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 is in good health. I herby give permission to participate in all dance activities. |
Parent/Guardian signature __________________________________
Thank you for choosing our studio!

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