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Rachel Park Dance Center - Registration

Name * First Last
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Phone * - (###) - ### ####
Cell Phone - (###) - ### ####
Email
Age at registration *
Birthdate
Grade
Parent or Guardian *
Person Responsible for Tuition Payment

(If not same as above)
Emergency Contact *
Phone * - (###) - ### ####
Are there are any medical conditions we should be made aware of?

(If yes, please describe)
Please describe this student's previous dance training, if any.

(i.e., where, what forms, number of years, etc.)
Why did you choose the Rachel Park Dance Center? *

This question is important to us! Please take the time to answer.
Classes

Please choose the appropriate class(es) from the fields below. Please contact us if you have any questions.
Pre-School 1

Age 3
Pre-School 2

Age 4
Primary 1

Age 5-6
Primary 2

Age 6-7
Elementary
Ballet-Thursday, 4:30-5:15 Tap-Thursday, 5:15-6:00 Jazz-Wednesday, 4:30-5:15 Hip Hop-Wednesday, 5:15-6:00

Age 7-8
Intermediate
Ballet-Tuesday, 4:30-5:15 Tap-Tuesday, 5:15-6:00 Hip Hop-Wednesday, 4:30-5:15 Jazz-Wednesday, 5:15-6:00

Age 8-10
Junior
Ballet-Tuesday, 5:15-6:15 Tap-Tuesday, 6:15-7:00 Jazz-Monday, 6:00-6:45 Modern-Monday, 6:45-7:30 Hip Hop-Monday, 7:30-8:15

Age 10-13
Senior
Jazz-Wednesday, 6:00-6:45 Tap-Wednesday, 6:45-7:30 Hip Hop-Monday, 6:45-7:30

Age 13-18
Dance Company
Junior Company Senior Company
Registration fees:

$25 per student - $30 per family
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