Summer Class Form 2024
Please fill out the form below to start your registration for summer classes. If you have any questions, contact Uplift Dance at 224-828-0801 or upliftdanceducation@gmail.com
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Email *
Whee did you hear about us?
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Phone Number
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Parent's First & Last Name
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Dancer's First and Last Name
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Student's Birthday & Age
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Address
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Today's Date
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Use of child photo on Uplift Dance Education social media and website *
Emergency Contact & Phone Number *
 
Health Conditions or Allergies
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Parent/Guardian/Adult Participant Initials:
 I hereby give consent for the above named person to participate in dance and/or other physical activities under the direction of Uplift Dance Education
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Class Options

Classes Run June 3rd-August 2nd. Studio closed June 28th- July 7th.
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For registration, choose from our monthly tuition plans: $70 per month for 45-minute classes or $80 per month for 60-minute classes. If flexibility suits you better, opt for our punch card options: $55 for 3 classes, $85 for 5 classes, or $175 for 10 classes. Select the plan that aligns with your preferences and join us at Uplift Dance Education for an enriching dance journey. *
Uplift Staff will follow-up with this form to confirm your selections.Payment is due to secure your dancer's spot. There is a processing fee of  3.05% + $0.30 per transaction for credit or debit cards. Pay cash or check to avoid the processing fee. Please sign below with your initials and date.
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A copy of your responses will be emailed to the address you provided.
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