Class Registration Monday - Tell Us About Dancer First Name: Last Name: Please list the student's age and grade as of this coming September Birth Date: Age: Grade: School Hours: Physical Limitations/Referred By: Previous Dance Training: Contact Information Email Address: (Center Stage uses email as our primary means of communicating important studio information) Street Address: City: State: Zip: Home Phone: Parent 1: Work Phone: Cell Phone: Parent 2: Work Phone: Cell Phone: Class Selection Classes denoted with an * require an audition or recommendation. If your desired class is not appearing below the class is full and closed to registration. Please make another selection or call 203-329-6676 to be placed on the waiting list. Class: Class Choice 12021-22 Dance Year Day: Time: Class: Class Choice 22021-22 Dance Year Day: Time: Class: Class Choice 32021-22 Dance Year Day: Time: Class: Class Choice 42021-22 Dance Year Day: Time: Acknowledgment & Release Registration is complete only after first payment is received and studio waiver is signed. I hereby release Center Stage Dance Studio LLC from any and all liability and assume the risks of participating in the Center Stage Dance program. By signing, I acknowledge my responsibility in paying tuition, registration fees and costume charges. I further agree that I have read and agree to the Center Stage Dance Studio LLC Policies and Procedures, Tuition Schedule, Dress Code and COVID Protocols and Safety Guidelines, all of which are located on our website, http://www.centerstagedancestamford.com. By submitting this form, I hereby give Center Stage Dance Studio LLC permission to photograph and/or video my child(ren) and consent to the use of material for advertising, marketing and promotional purposes. Insert you full name:
