This form is for the Kenmore Location for the 2011-2012 dance season.

The registration fee and first month's tuition are due at the time of registration, but no later than the first class. Each student must also return a signed tuition/fees policy. This policy sheet is given so all of our policies are clearly outlined and understood by all.  Also, each student must return a liability waiver. These printable forms can be found here:

http://www.dancetime.citymax.com/printable_required_forms.html 

Your registration fee of $10.00 per student and first month's tuition may be paid online on our Online Payments page, or by sending a check or money order to:

Jamie Kiefer/Dance Time

159 South Irwinwood Rd

Lancaster, NY, 14086

* Required fields
Name *
E-mail Address *
Dancer's Full Name
Full Mailing Address (Include City, State, Zip)
Phone # 1
Phone # 2
Date Of Birth
Age As Of September 2011
Any Allergies Or Medical Conditions? Please explain.
If new student, please describe any previous dance training.
	I understand that my child's photo/video may appear on studio website or in other advertisements to promote the studio. I consent to the release of my child's photo/video for advertising purposes. (Dance Time never releases students names with photos).
Emergency Contact (Name, Phone Number, And Relationship to dancer). Please list someone other than parent in case parent cant be reached.
Classes Registering For:
	Creative Movement, Ages 2-3, Saturday 9:30-10:15AM
	Preschool Combo, Age 3, Saturday 10:15-11:00AM
	Preschool Combo, Age 4, Saturday 10:15-11:00AM
	Preschool Combo, Ages 3-4, Wednesday 5:00-5:45PM
	Kinder-Combo Age 5, Saturday 11:00AM-12:00PM
	Kinder-Combo Age 5, Thursday 4:30-5:30PM
	Kids Combo, Age 6 - Saturday 11:00AM-12:15PM (Ballet/Jazz)
	Kids Combo Age 6 Thursday 5:30-6:45PM (Tap/Jazz)
	Ballet, Ages 7-8 Monday 4:15-5:15PM
	Ballet, Ages 9-11, Wednesday 5:30-6:30PM
	Jazz, Ages 7-8, Monday 5:15-6:00PM
	Jazz, Ages 9-11, Wednesday 5:45-6:45PM
	Jazz, Ages 12-15 - Monday 6:15-7:15PM
	Lyrical, Ages 8-11 - Tuesday 4:00-5:00PM
	Lyrical, Ages 12-15 Tuesday 7-8:15PM
	Hip Hop, Ages 6-8 - Saturday 12:15-1:15PM
	Hip Hop, Ages 8-10 - Saturday 12:00-1:00PM
	Hip Hop, Ages 11&up, Thursday 4:00-5:00PM
	Acrobatics, Ages 5-6 - Tuesday 4:00-5:00PM
	Acrobatics, Ages 7-9 - Tuesday 6:00-7:00PM
	Acrobatics, Ages 9-11 - Tuesday 5:00-6:00PM
	Acrobatics, Advanced** - Monday 6:30-8:00PM
	Musical Theater, Ages 8-11 - Saturday 1:00-2:00PM
	Musical Theater, Ages 11&up , Monday 7-8PM
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