Student Registration Form

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Email *

Student's First Name *

Student's Last Name *

Student's Birthday *

YYYY

Parent/Guardian's First Name *

Parent/Guardian's Last Name *

Grade for 2024/25 School Year *

Phone Number *

Address 1 *

Address 2

City *

Zip Code *

Emergency Contact Name *

Emergency Phone Number *

Please Select a Class *

Consent Form *

By checking the box, I give permission for the above student to participate in classes, rehearsals, and performances provided by Tiffany Dance Co. I understand that enrollment is at the risk of the student. I do not hold Tiffany Christenson, any affiliated teachers, or building owners liable for any injury or illness suffered for any reason while at Tiffany Dance Co. I understand that the enrollment is at the risk of the student. I give permission to the owners and/or employees of Tiffany Dance Co. to seek medical care for any medical attention deemed necessary for my student in the case of an emergency. I understand and will abide by the policies outlined in the Registration Agreement, including tuition payment, costumes, performance fees, dress code and code of conduct.

I consent

Required

Signature of Parent/Guardian *

Type your name here as a signature marking the completion of the registration form.

A copy of your responses will be emailed to the address you provided.

Submit

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