Please note:
By completing and submitting this form, you are making an official, formal application to this program.


Dancer's Name:


Address:


City:


State:


Zip Code:


E-Mail:


Dancer's Age:


Years of Dance Training:


Parent's Name:


Parent's Phone:


What Classes Do You Desire?

Ballet
Jazz
Modern
Tap

Questions / Comments:


How Did You Hear About Twin Rivers Dance Academy:

Please Select One: Internet Word of Mouth Publication Current / Former Student

Agreement:

By clicking the submit button, I agree to the following statements.

I understand that despite all care, injuries my occur during dance training. I agree not to hold the teachers or director of the school, or the landlord of the building responsible for such injuries. I also understand that enrollment is for the complete semester and that I am responsible for all tuition whether or not the student completes the semester. Tuition will be refunded only if the student must withdraw for medical reasons. A $10.00 registration fee will be included in the first semester payment.