Tricia Sloan Dance Center
Registration Form 2010-2011

PARENT INFORMATION:   (Please PRINT clearly) 

Home Phone:  
Parent's Last Name:  
Mother's First Name:   
Father's First Name:  
Street Address:  
City:  
State:  

Zip Code:

 
Email Address:  

Please identify all CHILDREN enrolling into class(es):

Child First Name

Child Last Name 

DOB
mm/dd/yy

Dance
Level
       /      /  
       /      /  
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Please provide the following information for each class to be enrolled into:

Child First Name: CLASS CODE: Child First Name: CLASS CODE:
1.     4.    
2.     5.    
3.     6.    
If you are enrolling in more than 6 classes CLICK HERE  Registration Form Page 2