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Step 1 of 3 33% Registration Date* Date Format: MM slash DD slash YYYY $25 Registration Fee Per FamilyName* Student's Name Classes Enrolled In* Pre-school/Kindergarten Movement Ballet/Jazz/Tap 1 Elementary (Ballet 2-4) Intermediate (Ballet 5-7) Advanced Modern dance Jazz and Hip Hop Tap Broadway Adult programs Age*Birthdate*Address* Street Address Address Line 2 City State Zip Code Phone*Alt Phone/Cell Phone(s) Parent(s)/Guardians* First Last Parent(s)/Guardians* First Last Parent(s)/Guardians First Last Parent(s)/Guardian(s) Email* Enter Email Confirm Email Parent(s)/Guardian(s) Email Enter Email Confirm Email Alt Contact and Number*Realtionship to Student*Dance Experience*None1-2 Years3-4 Years5+ YearsAny allergies or health conditions affecting his or her ability to participate in strenuous exercise or any additional info you would like us to know concerning your child?*
220 W State St. O’Fallon, IL 62269
618-632-1217
edancestation@yahoo.com
Everyday 10AM-9:00PM
