ENROLLMENT FORM
STEP by STEP DANCE ACADEMY


STUDENT NAME ________________________________AGE OF STUDENT_____

PARENT/GUARDIAN NAME_____________________________________________

ADDRESS_________________________________HOME PHONE_______________

____________________________________CELL PHONE _____________

PARENT EMAIL ADDRESS______________________________________________

STUDENT EMAIL ADDRESS_____________________________________________

ALL PHOTOS OF STUDENTS TAKEN THROUGHOUT THE SEASON MAY BE USED IN ADVERTISING OR
ON OUR WEBSITE.
***IF YOU DO
NOT WANT YOUR PHOTOS TO BE USED PLEASE SIGN
HERE__________________________________***


PARENT/GUARDIAN SIGNATURE________________________________________


PLEASE CIRCLE ONE:        
NEW STUDENT        RETURNING STUDENT


CLASS DAY:_______  CLASS TIME:_________  TEACHER:__________ PAID:    CHECK/CASH

                                                               
CK #__________________


*WE ONLY EXCEPT CASH OR CHECK – NO DEBIT OR CREDIT CARDS
*ALL RETURNED CHECKS WILL BE CHARGED A $30.00 RETURN FEE

*(to print forms, "highlight" or "select" which form(s) you would like to print,
then select "file", "print" then check the "selected" box in your printer options
and then click "apply" before clicking "OK".)
Ph: 262-902-6323    e-mail: studio716@wi.rr.com     web: www.sbsdanceacademy.com
7645 Pershing Blvd.,  Unit #C,  Kenosha, WI. 53142
PH: 262-902-6323
E-mail: studio716@wi.rr.com
Year-Round Enrollment Form