First Name:* Last:

Parents name:* Birthdate: Age:

Home Phone # Cell Phone #:

Do you receive text messaging? Yes No

Address:

City: State: Postal Code:

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Please select the class(es) you are enrolling in:

Monday
	4:00 - 5:00 Preschool Combo -
	5:00 - 5:30 Tiny Tots age 2 -
	5:30 - 6:30 Preschool combo 3-4 - FULL
	6:00 - 7:00 Ballet/Tap/Jazz 1st/2nd gr -
	7:00 - 7:30 Hiphop ages 6-9 -
Tuesday
	4:00 - 5:00 Preschool Combo 3-4 -
	5:00 - 6:00 Preschool Combo Ballet/tap/tumbling -
	6:00 - 7:00 Ballet/Tap/Jazz age 7-9 -
	6:00 - 7:00 Ballet/Tap/Jazz age 5-6 -
	7:00 - 8:15 Teens Revolution -
	7:00 - 7:30 Hiphop -
Wednesday
	4:00 - 5:00 Jazz/ Contemporary -
	5:00 - 5:30 Hiphop -
	5:30 - 6:45 Ballet/Tap/Jazz /Hiphop 6-8 -
	5:30 - 6:30 Preschool Combo Ballet/Tap/Tumbling -
Thursday
	4:00 - 5:30 ballet/tap/jazz/hiphop ages 8-10 -
	5:30 - 6:30 Preschool Combo - FULL
	6:00 - 6:30 Tiny Tots age 2 -
	6:30 - 8:00 Jazz/Lyrical/Hiphop grade 6 & up -
Friday
	4:00 - 5:30 Starz Pom Squad -
	4:45 - : Tumbling/acro -

Monday
	4:00 - 5:00 Preschool Combo -
	5:00 - 5:30 Tiny Tots age 2 -
	5:30 - 6:30 Preschool combo 3-4 - FULL
	6:00 - 7:00 Ballet/Tap/Jazz 1st/2nd gr -
	7:00 - 7:30 Hiphop ages 6-9 -
Tuesday
	4:00 - 5:00 Preschool Combo 3-4 -
	5:00 - 6:00 Preschool Combo Ballet/tap/tumbling -
	6:00 - 7:00 Ballet/Tap/Jazz age 7-9 -
	6:00 - 7:00 Ballet/Tap/Jazz age 5-6 -
	7:00 - 8:15 Teens Revolution -
	7:00 - 7:30 Hiphop -
Wednesday
	4:00 - 5:00 Jazz/ Contemporary -
	5:00 - 5:30 Hiphop -
	5:30 - 6:45 Ballet/Tap/Jazz /Hiphop 6-8 -
	5:30 - 6:30 Preschool Combo Ballet/Tap/Tumbling -
Thursday
	4:00 - 5:30 ballet/tap/jazz/hiphop ages 8-10 -
	5:30 - 6:30 Preschool Combo - FULL
	6:00 - 6:30 Tiny Tots age 2 -
	6:30 - 8:00 Jazz/Lyrical/Hiphop grade 6 & up -
Friday
	4:00 - 5:30 Starz Pom Squad -
	4:45 - : Tumbling/acro -

Parent/Guardian name: Date:

DANCE ARTS STUDIO
401 Hwy 11 North
Ellisville, Mississippi 39437