Enrollment Form

Please complete this form and click the "Submit" link at the bottom when you are done. Required fields are marked with '*'.

Studio Location	Class Time	Today's Date
Student's Name (1)*	Date of Birth*	Age*	Email
Student's Name (2)	Date of Birth	Age	Email
Street Address*
City*		State	Zip
Father's Full Name		Employed By	Email
Mother's Full Name		Employed By	Email
Home Phone		Mother's Work Phone
EMERGENCY PHONE (other than home phone please)*
Billing Email*
Previous Dance Training in years		Where child studied previously
How you learned of our school
IF SOMEONE OTHER THAN THE PARENTS IS TO BE BILLED FOR LESSONS, GIVE THE FOLLOWING INFORMATION
Person to be billed is
Street Address
City		State	Zip
ATTENTION PARENTS! Tuition is payable at 1st class to register, including a $25.00 registration fee per family, per season. Tuition must be paid each 6 weeks as billed if pupil is to remain with our school. NO CREDITS NOT REFUNDS. Check with our office as to class make-up procedure and class attire for your child. A recital will be held in December for our Jazz Students, Special Group Dance Students & Special Group Gym Students. A recital will be held in June for Regular Dance and Jazz students and SPECIAL GYM STUDENTS. Details will be forthcoming. Your child's participation in either or both recitals is by your choice. We'll do our best to give your child the finest training available.

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Harrison Dance Studios • 321 South High Street • West Chester, PA 19382
(610) 692-6144 • Info@HarrisonDanceStudios.com