Richards School of Dance - Winter Adult Classes

Richard's School of the Dance Winter Adult Classes

Fall Adult Classes
(13 weeks - $85)
Beginning Mon. Jan. 9th and Tues. Jan. 10th
Ends Mon. April 2nd and Tues. April 3rd

(Payable IN FULL before start date)
NO Refunds!

Monday	Tuesday
Adult Tap Fit 6:30 - 7:25pm	Adult Hip Hop 7:15 - 8:10pm

Full Name*
First Name Last Name
Home Phone*
- Area Code Phone Number
Cell Phone*
- Area Code Phone Number
Work Phone
- Area Code Phone Number
E-mail*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Birth Date*
Month Day Year
Age*
Any conditions we should be aware of?
Classes you would like to enlist in?

Adult Hip Hop Adult Tap Fit
Parent/Guardian Signature*
Date*
Month Day Year
Should be Empty: