Registration Information

You have three registration options:

1. Please print out this form and mail it in, with payment, to the address on the bottom.

2. Complete this form online and it will be sent to me as an email.

3. Please call 927-0555 and leave a message - I will get back to you and confirm registration.

If you have any questions, please call 927-0555 or email Jayne at gottjayne@gmail.com

2009 Fall Youth Registration
Student Name
age		Male/Female?	female	male
mailing address
city
zip Code
email
phone: home
phone: cell
class(es)	Hip Hop/Street Jazz Monday, 4 - 5pm	Hip Hop/Street Jazz Monday, 5 - 6pm	Intermediate Technique Tuesday, 5:00 - 5:50pm	Hip Hop Thursday, 4 - 4:45
	Hip Hop Thursday, 4:45 - 5:45	Salsa Friday, 4:30 - 5:30pm
comments

Studio policies
Class packages begin the day of the first class taken.
Packages may not be shared with anyone else.
Packages are non-refundable.
Package expiration dates may be extended with the purchase of a new class package of equal or greater value