Child's Name *

First Name

Last Name

Child's Birthday *

MM

DD

YYYY

Classes I am interested in for Child 1 *

Preschool Dance (3-5 Years Old)

Ballet

Jazz

Contemporary

Hip Hop

Little Champs Taekwondo (4 Years Old)

Taekwondo

Please let us know which day of the week you would prefer (please refer to schedule and click all that apply)

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

2nd Child's Name

First Name

Last Name

2nd Child's Birthday

MM

DD

YYYY

Classes I am interested in for Child 2

Preschool Dance (3-5 Years Old)

Ballet

Jazz

Contemporary

Hip Hop

Little Champs Taekwondo (4 Years Old)

Taekwondo

Please let us know which day of the week you would prefer (please refer to schedule and click all that apply)

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

3rd Child's Name

First Name

Last Name

3rd Child's Birthday

MM

DD

YYYY

Classes I am interested in for Child 3

Preschool Dance (3-5 Years Old)

Ballet

Jazz

Contemporary

Hip Hop

Little Champs Taekwondo (4 Years Old)

Taekwondo

Please let us know which day of the week you would prefer (please refer to schedule and click all that apply)

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Mother's Name *

First Name

Last Name

Mother's Phone Number *

(###)

###

####

Father's Name

First Name

Last Name

Father's Phone Number

(###)

###

####