Summer Registration

Use this form to register your child for our summer classes. Payment in full is due within 7 days or your registration will be cancelled. You may visit our "online payments" page to use your Visa/MC/Discover OR you may mail a check or money order to:

Jamie Kiefer/Dance Time

159 South Irwinwood Rd

Lancaster, NY, 14086

Please note: Summer class tuition is non-refundable after June 1, 2010.

* Required fields
Name *
E-mail Address *
Parent's Names
Phone # 1
Phone # 2
Home Address - include city & zip code
Date Of Birth
Age as of July 1, 2010
Any allergies or medical conditions? Please Explain.
Classes Registering For:
	Tots Dance-Ages 2-3 - Tuesday 4:00-4:45PM
	Tots Dance - Ages 2-3 - Wednesday 9:15-10:00AM(CURRENTLY FULL)
	Tots Dance Ages 2-3 - Thursday 10:00-10:45AM (Currently FULL)
	Tots Dance Ages 2-3 Thursday 10:45-11:30AM
	Preschool Dance - Ages 3-4 - Tuesday 4:45-5:30PM(CURRENTLY FULL)
	Preschool Dance - Ages 3-4 - Wednesday 10:00-10:45AM(Currently FULL)
	Preschool Dance Monday 5:00-5:45PM
	Preschool Dance - Ages 3-4 - Thursday 9:15-10:00AM
	Kinder-Combo Ages 4.5-6 - Tuesday 5:30-6:30PM(CURRENTLY FULL)
	Kinder-Combo Ages 5-6 - Wednesday 10:45-11:45AM
	Acrobatics - Ages 6-7 - Tuesday 10:00-11:00AM
	Acrobatics Ages 6-7 - Wednesday 4:00-5:00PM (CURRENTLY FULL)
	Acrobatics Ages 8-11 - Tuesday 12:00-1:00PM(Currently FULL)
	Ballet Ages 7-10 - Thursday 5:00-6:00PM
	Hip Hop Ages 7-8 - Wednesday 5:00-6:00PM
	Hip Hop Ages 9-10 - Tuesday 1:00-2:00PM
	Hip Hop Ages 11 &up - Wednesday 6:00-7:00PM
	Musical Theater Dance -Ages 8-12- Tuesday 11:00AM - 12:00 PM
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