Student Registration Form

To register for your dance class(es), please complete these 4 easy steps:

1. print this form and complete all required fields,
2. print, read and sign the Release of Liability form
3. check the box below indicating that you are attaching a signed release of liability form,
4. mail this registration form, the signed release form and your check to the address below.

1. Student Information * indicates required field
We Respect Your Privacy. Rest assured that we will neither give nor sell your personal information to third parties as detailed in our privacy policy.
First Name*	______________________________
Last Name*	______________________________
email address*	__________________________________________________________________________
Street Address	___________________________________________________
2nd Street Address	___________________________________________________
City	__________________________	State	__________________________
Zip Code	__________________________
Daytime Phone*	__________________________	extension	__________________________
Evening Phone*	__________________________
2. Choose Your Classes* Check the box next to each class in which you wish to enroll.
	Class #1 description with dates, times, location and pricing
	Class #2 description with dates, times, location and pricing
	Class #3 description with dates, times, location and pricing
	Class #4 description with dates, times, location and pricing
	Class #5 description with dates, times, location and pricing
Total amount of check being mailed:*			$________________
3. Release of Liability Please read the Release of Liability and indicate your agreement by checking the box below.
*I have attached a signed Release of Liability Form.
4. Payment
	Please mail this form, the signed release of liability and your check payable to:       Suzanne Hamby       18 Dartmouth Drive       Framingham, MA 01701