Mathews Dance Studio
Welcome
About
Contact
Performances
Recital 2019
Recital 2018
Recital 2017
Creative Movement
Saturday 10:45 - 11:30
Contact One:
This contact should be a primary caregiver of the dancer. This contact will receive class emails and information.
*
Indicates required field
Name
*
First
Last
Relationship to Dancer
*
Postal Address
*
Email
*
Cell Phone Number
*
Home Phone Number
*
Contact Two:
This person will ONLY be contacted in cases of emergency when Contact One cannot be reached.
Name
*
First
Last
Relationship to Dancer:
*
Cell Phone Number
*
Home Phone Number
*
Dancer Information:
Name
*
First
Last
Gender
*
Male
Female
Birthdate
*
Current Age
*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Grade Level
*
N/A
Pre-School
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Name of School Child Attends (If applicable)
*
Known Allergies
*
Notes or Concerns for Teacher
*
Policies
Attendance and Tuition: Tuition is per session, not class. Tuition will not be decreased for illness, travel, or family obligation; however, make-up dates are available for any of these instances.. If a class is cancelled due to weather a make-up day will be assigned.
Please Select
*
I have read and understand.
Liability: I am aware that movement and dance classes carry a risk of physical injury. I agree that Mathews Dance Studio and staff shall not be liable in any way for injuries sustained during any of its functions or classes.
Please Select
*
I have read and understand.
Publicity: Mathews Dance Studio shall have the right and permission to use, publish and/or reproduce videos and photographs taken during MDS functions and classes.
Please Select
*
I have read and GIVE permission.
I have read and DO NOT give permission.
Submit
Welcome
About
Contact
Performances
Recital 2019
Recital 2018
Recital 2017