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Please print this out, fill it in, and mail to: Kathy Marino Dance Studio
                                                           2668 Lewisville-Clemmons Rd.
                                                           Clemmons, NC 27012

Or copy and paste it into an email. E-mail to: [email protected]
                          Registration Form

Name of Student ______________________________________

Age _______________

Mother's Name _____________________________

Father's Name ______________________________

Address ________________________________________
            ________________________________________

Phone (Mother)  H: ____________________
                        W: ____________________

Phone (Father)   H: ____________________
                        W: ____________________

Please list the days and times that are NOT convenient for you:
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________

Check classes of interest:
_______  Mommy & Me - 2 & 3 years old
_______  Children's Ballet & Tap Combo - Ages 4 to 6
_______  Tap
_______  Jazz
_______  Ballet
_______  Acrobatic
_______  Flamenco
_______  Teen Dance Classes
_______  Adult Dance for Mind & Body


                                                 Schedule
Our dance season begins in August and ends at the end of May.
There will be a recital to end our season in May.
All students are welcome to participate.
Back to Kathy Marino Dance Studio Main Page
Hosted by www.Geocities.ws

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