Registration Name of Mother/Gaurdian Email of Mother/Guardian Home Address of Mother/Guardian Phone of Mother/Guardian Name of Father/Guardian Address of Father/Guardian Phone of Father/Guardian Email of Father/Guardian Preferred Method of Payment Cash Check Full Name of Student Preferred Name of Student Student's Date of Birth If student attends school, please specify where Does the student have any previous dance experience? Yes No If answered "yes" to previous question, please describe previous experience. Please list any medical issues (allergies, asthma, injuries, disabilities, etc.) Insurance Company Insurance Policy Number Which Class(es) the student wishes to enroll in: I have read and agree to the terms, policies, and expectations as stated in the Cadence Dance Studio Workshop/Class Handout
