| Students Name: _______________________
Parent(s): _______________________________ Address: ____________________________________________________________________ Postal Code: __________ Telephone: Home _______________ Work _______________ E-mail: ____________________ Birthdate: _____________________ Age: _____ Previous Experience: ___________________________________________________________ _____________________________________________________________________________ CHECK SUBJECTS Pre-Dance __________ Ballet __________ Tap __________ Jazz _________ Jazz Open __________ Tap Open __________ Ballet Open __________ Stretch __________ Musical Theatre __________ |