Registration

Anita Deprey Studio of Dance & Performing Arts Center

For your child's Level, estimate to the best of your knowledge. Miss Anita will be sure to put them in the right class for their age & ability!

Registration 2010-2011

Parent's Name *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Cell Phone Number *

Home Phone Number *

Work Phone Number *

Student's Name(s), Age(s), Birthdate(s), Level, Years with Miss Anita OR Years with other *

Please write Student's name followed by Age, Birthdate, Level, Years completed with Miss Anita, OR Years completed with another studio

Pre-School ( 2-4 yrs old ) *

Tap & Ballet Combo class

The Tap & Ballet Combo class, is a 45 minute class!

Level 6 ( 4-6 yrs old ) *

Tap & Ballet Combo class Acro- Gymnastics

The Tap & Ballet Combo class, is a 45 minute class!

Level 5 ( 5-7 yrs old ) *

Acro - Gymnastics Ballet Jazz Tap

Check 2 or 3 and make it a Combo Class!

Level 4 ( 7-10 yrs old ) *

Acro - Gymnastics Ballet Hip Hop Jazz Tap

Level 3 ( 9-12 yrs old ) *

Acro - Gymnastics Ballet Hip Hop Jazz Lyrical Tap

Please note. If you are taking Lyrical, you MUST take Ballet.

Level 2 ( Intermediate / Advanced ) *

Acro - Gymnastics Ballet Contemporary Hip Hop Jazz Lyrical Pointe Tap

Please note. If you are taking Lyrical, OR Contemporary you MUST take Ballet.

Adult / Recreational *

Ballet Jazz Tap

How did you hear about my Studio? *

Already a Student of Miss Anita! Internet Search Friend Other

If Other please specify: *

Additional Comments, Concerns or Specifications for Miss Anita *

Type of Registration *

Your Registration Fee is due immediately following the submission of your Registration form.

'Where learning is fun, & Dance comes from the heart.'