New Registration & Re-registration after June 11th. ---- $15.00
Child’s Name: __________________________ Age: ____ Date of Birth: ________
Address: _________________________ City: ___________ St. _____ Zip _______
School Attending: _____________________________________ Grade: _________
Mother or Guardian’s Name: _______________________ Occupation:_________
Home Phone: _______________ Cell Phone: ____________ Email: ___________
Father or Guardian’s Name: _______________________ Occupation: _________
Home Phone: _____________________ Cell Phone: ___________________
Please fill in how many of each classes you would like:
Ballet __, Jazz ___, Pointe ___, Tap __, Lyrical __, Combo.(5 – 7) __, Pre-School (3 ½) ___
If you came from another studio please enter the following information.
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 arrorney fees, interest etc. I have read all
information and accept it.
2009 -2010
Any medical information we should be aware of: ______________________________________
Previous dance training (classes): ____________________ Where: __________ How long: _____
Sandy Stramonine School of Dance Registration Form
Please print, fill out, and mail to:
Sandy Stramonine School of Dance
3992 West Walworth Rd.
Macedon, NY 14502
Signed: __________________________________________ Date: _________________