2022 Registration Form
Diversity Dance Studio
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Email *
Student Name:
Student Birth Date: *
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DD
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School: *
Grade: *
Parent/Guardian Name: *
Mailing Address: *
Guardian Cell Phone Number: *
Student Cell Phone Number:
Guardian Email Address: *
Method of Payment *
In the event you are unable to reach me, in the case of accident or injury, I give my permission for treatment as deemed necessary by staff or emergency personnel. I also release Diversity Dance Studio and its staff of liability in case of injury or accident incurred to my child. *
Required
I have read all of the studio policies and information including tuition, late policies, classroom expectations, insurance, attendance, holiday policies, dance wear and the conditions of enrollment. I fully understand and agree to abide by these policies. *
MONDAYS
TUESDAYS
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THURSDAYS
A copy of your responses will be emailed to the address you provided.
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