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GLENNS SCHOOL OF DANCE REGISTRATION FORM

Please send us your information by filling out the form below. A member of our staff will return an email to you confirming your class times and monthly tuition totals. You will not be enrolled until after we complete that process with you.

Name
Birthdate
Current Grade


CONTACT/ACCOUNT INFORMATION:

First & Last name of adult responsible for account:  
 
 
Relationship to Student
 
Contact Phone
 
 
Contact Email
 
Contact Address/City/Zip
 


ENROLLMENT INFORMATION:

Please list all desired classes (List options as your first choice may be filled):  
Please list all prior dance training (Where, When, Duration, Dance Type, etc):  
Please list any Health Concerns:  
   


*I recognize that dance does involve a risk of harm or injury, therefore, I agree to hold Glenns School of Dance, its teachers and representatives, harmless from any injury I/my child may incur during my/my child’s training here. I have read and agree to abide by the policies, procedures, & dress code of Glenns School of Dance. I grant Glenns School of Dance the use of photographs of me/my child with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. By submitting this form, I agree to the terms above.