Nielsen School of Dance 2021/2022 Registration Form

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This is the official 2022- 2022Dance registration form. If you have multiple children you can sign them up on one form. We will contact you to complete their entire registration. If you have any questions please call or text 208-595-8188 or email nsdance@cableone.net.

Thank you!

Dancer 1: Child's Full Name *

Dancer 1: Child's Birthday *

年

月

日

Dancer 1: Child's Current Age *

Dancer 1: Child's Grade for the 2021-2022 year *

Dancer 1: Child's T Shirt Size *

Dancer 2: Child's Full Name

Dancer 2: Child's Birthday

年

月

日

Dancer 2: Child's Current Age

Dancer 2: Child's Grade for the 2021-2022 year

Dancer 2: Child's T Shirt Size

Dancer 3: Child's Full Name

Dancer 3: Child's Birthday

年

月

日

Dancer 3: Child's Current Age

Dancer 3: Child's Grade for the 2021-2022 year

Dancer 3: Child's T Shirt Size

Mother's Full Name *

Mothers Employment *

Mothers Phone Number *

Father's Full Name *

Fathers Employment *

Fathers Phone Number *

Email Address *

Mailing Address *

Emergency Contact and Phone Number *

Which class are you interested in for the 2021-2022 year? *

Monday 3:45-4:25 3 year old combo class

Tuesdays 10:00-10:55 4, 5, and 6 year old combo (Pre K-K)

Tuesday’s 3:55-4:50: 5-6 year old combo class (K-1st) Dance experience

Tuesdays 4:15-5:10 4 year old combo

Tuesdays: 4:55-5:50: 9-12 year olds (Going into 3rd-6th) Has had dance experience

Tuesdays 5:15-6:10 7-9 (Going into 2nd-3rd Grade)

Tuesdays 6:15-7:10: 8-13 (Going into 4th-7th Grade)

Wednesdays 10:00-10:55 4-5 year old combo class (Pre-K and K)

Wednesdays 3:50-4:45: 6 and 7 year old combo class (1st-2nd))

Thursdays 4:00-4:55: 4-5 year old combo

必填

Please list any special conditions, medications, allergies we should know about *

Where did you hear about Nielsens? *

List any dance experience you’ve had *

Are you interested in trying out for our competition dance teams? (Need to have 2 years of dance experience)

Yes

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