DANCE EXPRESS REGISTRATION FORM

68 Hartford Turnpike
Tolland, CT 06084

Studio (860) 871-1922
Fax (860) 871-1571

Classes are filling up fast, please contact the studio directly rather than complete the online registration form here. updated 9/15/07

Please complete your application on-line here,
or print the form and return with your payment to Dance Express.

DANCE EXPRESS - REGISTRATION FORM

PLEASE COMPLETE THE FOLLWING FORM AND CLICK 'SUBMIT'

ONE REGISTRATION FORM PER CHILD PER CLASS

STUDENT’S NAME: BIRTHDATE
YEARS OF DANCE COMPLETED CURRENT STUDENT: YES NO

PARENT’S NAME:

PHONE: (C):

ADDRESS: TOWN: ZIP:

Select Days:

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Enter Age/Level:

Enter Class Time:

Select Class Type:

Ballet
Jazz / Hip Hop
Hip Hop
Progressive Movement
Jazz
Tap
Acro / Jazz
Tap / Jazz
Lyrical
Tap / Progressive
Mommy & Me
T L J

Comments/ Questions

TOTAL:

*PAYMENT DUE IN FULL AT REGISTRATION *

AMT PAID:

$10 registration fee is per child, NOT per class.

DANCE EXPRESS - 68 HARTFORD TURNPIKE - TOLLAND , CT 06084 - (860) 871-1922