2008/09 FALL ENROLLMENT REGISTRATION FORM

Name:_____________________________________       Age:_____________________________

Address:_______________________________________________________________________

City/State/Zip:___________________________________________________________________

Home phone:_________________________       Work phone:_____________________________

E.mail:_______________________________       Cell Phone:______________________________

Person responsible for payments:_____________________________________________________

If student is a minor, Guardian’s Name:________________________________________________

Is there a weakness we should be aware of?____________________________________________

List previous training if any:_________________________________________________________

Why did you choose Flint’s?________________________________________________________

Class/Level/Dates____________________________       $30 deposit________________________

Class/Level/Dates____________________________       $30 deposit________________________

Class/Level/Dates____________________________       $30 deposit________________________

Class/Level/Dates____________________________       $30 deposit________________________


Flint's Dance Studio, Inc.
2508 Milburn Boulevard Mishawaka, Indiana 46544
Tel: 574-255-5575
FAX: 574-255-5575
Internet: info@flintdance.com


Send mail to flintdance@hotmail.com with questions or comments about this web site.
Copyright © 2007 Flint's Dance Studio, Inc.
Last modified: 04/25/08