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Student's name:___________________

Date of birth:_____________________Age as of Sept.1st. ________


City, State, Zip:___________

Day phone:_____________ Evening phone:___________
Email address:_____________________________________
How did you hear about us: __________________________________________
Emergency Contact:____________________________________
Previous dance experience:_____________________________

Student is registering for the following classes:
Please check all that apply.


Tumbling____________________________ Ballet________________ 

Modern___________________________ Lyrical__________________

Combo class (ages 3-6)_______________________​

I understand that Hanf Dance Studio charges a fiscal school year rate and is allowing me to pay this yearly rate in 10 installments. Payments are expected each month as long as my child continues throughout the entire school year. Monthly payments are for my convenience and must be paid by the 7th of each month. I am responsible for knowing when my payment is due, and I do realize that I am subject to a $10.00 late fee if my payment is not made by the 7th of each month. A $30.00 bank fee will be charged on all returned checks. 

(  ) Please check this box and sign below to acknowledge that​ you have read and agree to all of the studio's policies. 


(Payer's Signature) _______________________________________________________________

Date _______________________________________

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