2017 – 2018 Registration Form
Please print this form and mail it with registration fee to enroll to:
Sandy Stramonine School of Dance, 3992 W. Walworth Rd, Macedon, NY 14502
Re-registration paid before June 11th. ---- $ 10.00    New Registration ---- $15.00
Please note fees are non refundable 
Child’s Name: _____________________________   Age: ____    Date of Birth: __________
Address: ____________________________   City: ­­­­_____________ St. _____ Zip _______ 
School Attending: ________________________________________   Grade: ____________
Parent or Guardian’s Name: ________________________   Occupation: ________________
Home Phone: _____________   Cell Phone: ____________ Email: ____________________ 
Please fill in how many of each class you would like:

Ballet __, Jazz __, Pointe __, Tap __, Lyrical  __, Combo.(5 – 7)  __, Pre-School (3 ½) __  

Any Medical information we should be aware of: ________________________________
All precautions are taken to safeguard our dancers from injury, but occasionally injuries do occur because of the physical nature of dance. Understanding such, I the undersigned, accept the normal risk involved in participating in any dance classes. I hereby assume all financial responsibility for the above student enrolled at the Sandy Stramonine School of Dance. I further understand that I will be charged for all classes unless I have notified the Studio in writing of canceling my child’s classes. In the event it becomes necessary to refer this account for collection, I, the undersigned will be liable for all collection fees, including attorney fees, interest etc. I have read all information and accept it.

Date: _________________ Signed: ______________________________________________

Call Us

sandysssdance@aol.com

315-986-4786 / 315-576-0630

3992 W. Walworth Rd.
Macedon, NY 14502