Student Registration

Student's Name *

Please fill out a separate form for each student

First Name

Last Name

Student's Birthday *

MM

DD

YYYY

Legal Guardian's Name *

First Name

Last Name

Guardian's Phone *

(###)

###

####

*

I have read and consent to Dance Factory East's Rules and Regulations. Please read our Rules & Regulations *

I Consent

*

I have read and consent to Dance Factory East's payment and tuition policies. Please read our Tuition Policy *

I Consent

*

I have read and consent to Dance Factory East's Liability Waiver and Release. Please read our Liability Waiver & Release *

I Consent