Registration Form

***Please print, mail and send with the registration fee of $25 (if you are a new student). Previous students may e-mail***


Parent/Guardian:______________________________________________________________________________

Address:_______________________________________________________________

___________________________________________ E-mail:__________________________________________

Phone Number: __________________________________

Child 1:____________________________________     

Age:________          D.O.B. ____________          Grade:________


Classes:           Tap              Ballet               Jazz (6+)             Jazz/Hip-Hip (9+)     Opening (9+only & w/my permission)

Child 2:____________________________________

Age:________          D.O.B. ____________          Grade:________


Classes:         Tap              Ballet               Jazz (6+)             Jazz/HH (9+)           

Child 3:____________________________________

Age:________          D.O.B. ____________          Grade:________


Classes:                Tap                Ballet                Jazz (6+)


Circle Night
s Preferred:                Mon                Tue                Wed                (Thur-for HS & JRH)

Adult Lessons: (over 18)      Tap         Jazz/HH         Ballet         Line Dancing         Couples         Hula Hooping      Drumming


Comments/Questions:_____________________________________________________________________________

______________________________________________________________________________________________

Send to:
Nicole's School of Dance
116 Meadowhill Rd
Manchester, ME 04351
                                      Registration Deadline: September 1st.
      ***There is a non-refundable registration fee of $25 for new students only***