2017/2018 Registration Form 
(Fill out and submit)

(A REGISTRATION IS NOT COMPLETE WITHOUT $20.00 REGISTRATION FEE - 
Please use "Buy Now" button at bottom of this page to submit with PayPal)

**if registering for summer, deposit of 1/2 is due with registration**
Dancer's Name
Parent's Name(s)
Address
E-mail Address
Home Phone
work phone
Emergency Contact
Relationship & Phone Number
Age (as of 9/1/17)
Birthdate
Grade
Previous Dance Training (place & length of time)
Allergies or Medical Conditions
How did you choose us?  (check all that apply)
Comments
CHECK SUBJECTS YOU WILL BE TAKING: (indicate how many of each)
*Pointe students must have teacher recommendation and be enrolled in at least 3 ballet classes per week
*Lyrical students must be enrolled in at least two ballet and one jazz class per week

Monthly Tuition is $50.00 for first class; $25.00 for second class; $15.00 for each additional class

MONTHLY TUITION - $
Monthly payments payable by Cash, Check or Credit Card
High Performance Dance Center
"Turning Dreams Into Reality"
STOP!!

After you click "Submit", return to this page and click "Buy Now" to submit your Registration Fee
Your spot will not be reserved without payment!!
Newspaper
Yellow Pages
Day Care
Website
Friend/Relative (list name in comment section
Other (explain in comment section)
TAP
JAZZ
CLASSICAL BALLET
PRIMARY TAP/JAZZ COMBO (Ages 5-6)
POINTE*
LYRICAL*
KINDERDANCE (Ages 3-4)
HIP-HOP
Postcard
ACRO