Nielsen School of Dance 2022/2023 Registration Form

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This is the official 2022- 2023 Dance registration form. If you have multiple children you can sign them up on one form. We will email you to confirm your registration. . If you have any questions please call or text 208-595-8188 or email nielsenschoolofdance@gmail.com.

Thank you!

Child’s Full Name *

Birthdate *

年

月

日

Age *

Dancer 1: Child's Grade for the 2022-2023 year *

Dancer 1: Child's T Shirt Size and shoe 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 2022-2023 year

Dancer 2: Child's T Shirt Size and shoe 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 2022-2023 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 2022-2023 year? *

Monday 3:15-3:55 3 year old combo class

Tuesday’s 3:55-4:50: prek-K Dance experience

Tuesdays 4:15-5:10 K-1st combo

Tuesdays: 4:50-5:45: 3rd-4th grade combo class

Tuesdays 5:15-6:10 3rd-4th grade combo

Tuesdays 6:15-7:10: 5th-7th grade combo

Wednesdays 9:30-10:10: 3 Year old combo class

Wednesdays 3:50-4:45: 5/6 year old combo class

Wednesday 4:15-5:10: 4 year old combo (WAITLIST)

Wednesday 5:15-6:10: 1st-2nd grade 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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Any other questions or comments?

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