Parent's name *

First Name

Last Name

Phone *

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Student's name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Student's Birthdate

MM

DD

YYYY

Classes

4-5th — Ballet / Wed 3:45 - 4:45 pm / Amy

4-5th — Modern/Contemporary (*alternating weeks) / Wed 4:45 - 5:30 pm / Micah Anne

4-5th — Jazz/Hip Hop / Wed 5:30 - 6:15 pm / Zander

Strength & Stretch (for pre-pointe, 5th grade only) / Wed 2:00 - 2:45 pm / Amy