Parent/Guardian Name *

First Name

Last Name

Phone *

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Student Name *

First Name

Last Name

Student D.O.B *

MM

DD

YYYY

Dance Style Wanting To Trial *

Tap

Jazz

Ballet

Hip Hop

Lyrical

Singing & Drama

Technique

Preferred Date - Please Select The First Monday of the week you would like to trial a class in. *

MM

DD

YYYY