ROBIN BRANDENBURG DANCE STUDIO * PRE-REGISTRATION FORM *

First name: Last name:

Street Address:

City: State: Zipcode:

Phone Number: EMAIL:

Student first name: Last name: Birthdate:

Perferred class day: MondayTuesdayWednesdayThursdayFridaySaturday

Select class(es) you are registering for: 30 minute beginning classes ($28/month first class $20/month each additional class) 30 Minute Floor Gymnastic Class 30 Minute RomperRoom toddler Class 30 Minute Ballet Class 30 Minute Ballet Pointe Class 30 Minute Jazz Class 30 Minute Tap Class 90 minute combination class ($68/month) Mix of Tap, Jazz, Ballet, Floor Gymnastics and more! 90 Minute Combination Class 30 minute Private class ($60/month) 30 Minute Private Class