Enrollment Form


Name: _________________________________________________                 email (Please print clearly)_______________________________

 ______    Return          Address __________________________                                  Phone Number ________________________________


City:    ________________________________  State ______  Zip Code ________          Phone Number ___________________________


If above student is a child, please list parents or guardians below.                Cell Phone Number _______________________

Parent/Guardian: ________________________________________________                  Birthday (mo/day/year) ___________________  

                                                                                                                                    Emergency Phone Number ______________________


Please select the classes you are registering for from the list below.  

Mondays:                                                                                                 Thursdays:

 _______   3:30-4:30 Tap Level Beginning, Ages 5-6                              _________  4:00-5:00pm, Breakdancing, Ages 6-14

 _______   5:00-6:00pm Tap Level 2, Ages 11-15                                   _________  4:30-5:30pm  Tap, Level 2 Ages 7-12

 _______   6:00-7:00pm Tap Level 2, Teens/Adults                                _________  6:00-7:00pm, Tap, Level 3, Adults


Tuesdays                                                                                                   Fridays: 

 _______  10:00-11:00am Tap Level 1 Adult                                            _________  3:30-4:30pm Tap Mommy/Daddy & Me, Ages 5-6

 _______   3:30-4:30pm Hip Hop Beginning, Ages 6-8                           _________  4:30-5:30pm  MTW, Ages 10-16

 _______   5:30-6:30pm Jazz, Intermediate, Ages 9-15 

 _______   4:30-5:30pm Hip Hop Beginning, Ages 8-12                                                       

 ________  6:30-7:30pm Hip Hop, Beginning, Adults/Teens                 Saturdays:             

                                                                                                                     _______ 10:00-11:30am Tap Performance Team, Ages 11-16 


 _______ 10:00-11:00pm Broadway Song & Dance, Adults                   

 _______ 11:00-12:00am Tap Level 1, Senior                                            

 _______ 3:30-4:30pm Tap Level .5, Ages 6-8                                                                 




____________  Class not listed, enter Title/Day/Time

____________  I would like my private slot from 2019 (Day: _____________, Time: _________________)                      

____________  I would like a new private slot as one becomes available  (Day: _____________, Time: _________________)



WAIVER OF LIABILITY                

                                                                                                                                                                                                            Date:  __________________________________


                            I/we, the student and/or parent(s) or legal guardian(s) of (student name): ______________________________________ _______________________________,a minor student, at Dance With Sherry Studio, agree to absolve, release and hold harmless Dance With Sherry Studio and/or its’ instructors, or other adult chaperones from any financial liability or claim for damages of any nature arising out of any event associated with the studio.  We realize that any event has certain risks involved and that every attempt will be made to safeguard students and belongings, but that no amount of precaution taken by the instructors can guarantee safety.



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