POSITION ONE SCHOOL OF DANCE

REGISTRATION FORM

2008-2009

Ages  2 ½  - 4:    First Steps __________          Ages  5 - 6:     Ballet/Tap __________                                  

Ages  7 – Adult:     Ballet__________     Jazz__________     Tap__________                                              

Pointe:     Beginner__________     Advanced__________                                                                             

Hip Hop:     Ages  5 – 7__________     Ages  8 – 12__________     (Fridays)                                           

*Options:     Monday – Friday____________     Saturday____________                                                  

PLEASE PRINT:

Student Name:___________________________________________ Age:______ Birthdate:______________

Address:__________________________________________________________________________________

                   Street                                                         town                                       state                          zip      

Home Phone:________________________________        Cell Phone:________________________________

Physical Limitations:_______________________________________________________________________

Mother’s Name:__________________________________________    Work Phone:  ___________________

Father’s Name:__________________________________________      Work Phone: ___________________

Military Personnel:    Yes ______   No ______   Expected Transfer Date:____________________________

NEW STUDENT HISTORY:                                                                                                                               

     Have you taken dance lessons before?   Yes_____  No_____   Location/School______________________

Ballet______yrs.     Jazz______yrs.     Tap______yrs.     Other:_____________________________________

How did you hear about Position One?_________________________________________________________

OFFICE USE ONLY:                                                            #  Family Members:______________

                                                                                                  Total Monthly Tuition: _________________

Monday: ____________________                                                                                                                        

                                                                                                                         Discount: _________________      

Tuesday:____________________                                                                                                                     

                                                                                                                               Total: _________________      

Wednesday:__________________                                                                                                                      

Thursday: ___________________                                           Registration Fee: ______________________

Friday:      ___________________                                                                                                                       

Saturday:  ___________________