NDC - Registration Form

Student Information

Name:
(Last)	(First)	(Name Wished to be Called)
Date of Birth:	Age:	Grade in School:
Parent/Guardian:
Address:
City & Zip Code:
Home Phone:	Work:	Cell:
Email Address:

Please fill out the class information below and return this with your $25.00 registration fee. Our Schedules and tuition rates are available on our web site for your convenience. All registrations will receive a confirmation
(Please Check the Appropriate Semester Below)

Semester Registering

Fall:

Spring:

Summer:

Subjects	Check Box	Day of Classes	Time of Classes
2 Year Old " Mommy & Me"	.	.	.
Pre-School Combination Classes	.	.	.
Age 2	.	.	.
Age 3	.	.	.
Age 4	.	.	.
Age 5	.	.	.
Kindergarten/Pre-K	.	.	.
1st Grade Classes	.	.	.
Ages 7 & Up	.	.	.
Ballet	.	.	.
Tap	.	.	.
Jazz/Hip Hop	.	.	.
Tumbling	.	.	.

Please list any additional information, requests or questions you may have: