Axis Dance Center Registration

All Tuition, Registration, Recital, and Costume Fees are Non-Refundable.  Registration Fee is $10.00 after Sept. 1st

Student's Name:

______________________________________

Parent/Guardian:

______________________________________

Birth date: _________ Age: ______

Address:

____________________________________________

City, State/Zip:

_______________________________________

Home Phone: _____________

Work Phone: ______________

Cell Phone: _______________

E-Mail: ______________________________________________

Emergency Contact Person & Phone:__________________________

Years Of Dance:

Ballet   _____

Tap      _____

Jazz     _____

Other   _____

Parent/Guardian Signature:

_____________________________

Date: ________________

Registering for:

Class:

 ______________________________________

Amt Paid$_______Date__________Cash/CC/Check___________

SELECT "FILE->PRINT" FROM YOUR BROWSER TO PRINT THE REGISTRATION FORM

Return This Form And Registration Fee To:

Axis Dance Center