Registration Form

By filling out this form, I understand that I will be held liable for my child’s monthly tuition unless I notify the front desk of any changes. If the undersigned does not carry through with this agreement, then he/she aggress to pay all collection costs.

NDN has the right to use any photos or videos of the dancers taken during classes or performance for advertisement use.

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Dancer's Name *

Parent Name *

Address *

City & Zip Code *

Cell Phone *

Email *

Age *

Birthday *

Grade in School *

Area of Dance student is interested in: *

• Ballet & Tap
• Ballet, Tap, & Jazz
• *Pointe
• Beginning Lyrical (ages 5-9)
• Intermediate/Advanced Lyrical
• Pee Wee Hip Hop (ages 3-6)
• Beginner Hip Hop
• Intermediate Hip Hop
• Toddler & Me
• Tumbling/Acro
• Technique Only
• *Competition Company
• *Solo
• *Duet
• *Trio

(*Speak with Mrs. Natalie):

Select Best (Flower) Option 1 for Classes *

View dance schedule to determine which best fits your child

Select Best (Flower) Option 2 for Classes *

View dance schedule to determine which best fits your child

Any Health Problems?

• Yes

Explain Health Issues

Medications

Has student ever taken dance?

• Yes

If yes, how long?

Name of Studio

How many years?

Parent Signature *

Referred By:

Submit