Summer Registration
Payment due by first class of the session.
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Email *
Student First Name *
Student Last Name *
Date of Birth *
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Guardian First Name *
Guardian Last Name *
Home Address *
Cell Phone Number *
Which session will you be registering for? *
Class choice(s) for Session 1
Class choice(s) for Session 2
I am interested in Adult Ballet (Open Level) Thursday 7:15
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Registration agreement: Merrick Dance Centre reserves the right to cancel, reschedule or combine classes. Merrick Dance Centre is not responsible for any injury that may occur on our premises. (Initial below) *
Registration agreement: I give permission for my child's photo to be used on social media platforms.
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