“Riversides Happiest Place to Dance” WELCOME TO DANCERS STUDIO NEW STUDENTS, REGISTER TODAY! Student's Name * Enrolling more than one Dancer? Please provide both names and D.O.B First Name Last Name Age & Date Of Birth * Medical Conditions or Allergies #1 Parent/ Guardian Name * First Name Last Name Email * Number * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country *Emergency Contact Contact Name * First Name Last Name Phone * (###) ### #### Selected Intrested COMBO- *Jazz, Ballet & Tap Lyrical Hip Hop Technique Private lessons Adult Tap Shows/ Recitals Message Thank you!
