Register Online

Registration for 2011-2012 Season

Please Note: Non Refundable Registration Fee of $25.00 Per Student will be added to your first tuition payment.

Students Name: *

Address: City: State: Zip:

Home telephone: * Present age: Birthdate:

Mother's name: Telephone: Cell:

Father's name: Telephone: Cell:

Email address: *

General Information

School dismissal time: Grade Fall 2011:

Former dance training/School: Number of years:

How did you hear about Showcase Dance Productions?

Emergency Information (If we can't reach parents)

Emergency name:

Telephone: Relationship to student:

Any health concerns, ongoing injuries, or food allergies?

* = required items

Please select the classes below that you wish to take

Monday
	9:45 - 10:30 Princess Ballet - Ages 3 & 4 Miss. Judy
	3:45 - 4:30 Broadway Babies - Ages 4 - 6 Miss. Michelle
	4:00 - 5:00 Tap / Jazz Combo Level 1 - Ages 10 - 13 Miss. Sheryl
	4:30 - 5:30 Combo Class 1 (Ballet & Tap) - Ages 5 & 6 Miss. Michelle
	5:00 - 6:00 Musical Theater - Ages 9 - 11 Miss. Sheryl
	5:30 - 6:30 Musical Theater - Ages 12 & up Miss. Michelle
	6:00 - 8::00 Ballet/Poine Technique Level 4 - Ages 11 & up Miss. Ashlee
	6:30 - 7:30 Irish Step Level 1 (S) - Ages 8 & up Miss. Terry
Tuesday
	9:45 - 10:30 Creative Movement - Ages 3 & 4 Miss. Judy
	10:30 - 11:30 Combo Class 1 (Ballet & Tap) - Ages 4 & 5 Miss. Judy
	3:30 - 4:30 Tap-Hop Level 2 - Ages 9 & Up Miss. Erika
	3:30 - 5:00 Combo Class 3 - Ages 7 - 9 Miss. Sheryl
	4:30 - 6:00 Disney Ballet w/ Jazz - Ages 9 & up Miss. Erika
	5:00 - 6:30 Lyrical With Ballet - Ages 10 & up Miss. Sheryl
	6:00 - 7:00 Tap Hop Level 3 - Ages 12 & up Miss. Erika
	7:00 - 9:30 Choreography Classes - Ages 17 & up Miss. Erika
Wednesday
	4:00 - 5:00 Musical Theater - Ages 5 - 8 Miss. Sheryl
	5:00 - 6:00 Theater Dance - Ages 8 & Up Miss. Laura
	5:15 - 6:00 Irish Step Level 1 (S) - Ages 5 - 7 Miss. Terry
	6:00 - 7:00 Intro To Theater - Ages 10 & up Miss. Laura
	6:00 - 7:00 Irish Step Level 2 / 3 (S) (H) - Ages 9 & up Miss. Terry
	7:00 - 8:00 Irish Step Level 1 / 2 (S) - Ages 10 & up Miss. Terry
Thursday
	3:45 - 5:00 Combo Class 2 (Ballet ,Tap & Jazz) - Ages 6 - 8 Miss. Sheryl
	4:30 - 5:30 Jazz Level 2 / 3 - Ages 10 & up Miss. Cait
	5:00 - 6:00 Irish Step Level 1 (S) - Ages 6 - 8 Miss. Katie
	5:30 - 6:00 Hip-Hop - Ages 10 & up Miss. Cait
	6:00 - 7:15 Ballet Level 4 - Ages 11 & up Miss. Michelle
	6:00 - 7:00 Irish Step Level 3 (S) (H) - Ages 12 & up Miss. Katie
	7:15 - 8:15 Irish Step (S)(H) - Adv. Level 4 Miss. Katie
	7:15 - 8:15 Modern Level 1 - Ages 10 & up Miss. Cait
Friday
	3:45 - 4:30 Zumbatomic - Ages 5 - 8 Miss. Susan
	4:30 - 5:30 Zumbatomic - Ages 9 - 12 Miss. Susan
Saturday
	9:00 - 10:00 Combo Class 1 (Ballet/Tap) - Ages 4 & 5
	10:00 - 11:15 Combo Class 2 (Ballet/Tap/Jazz) - Ages 6 - 8

Showcase Dance Productions, and the instructors, are not liable for personal injuries or loss of personal property. Each student may decline to participate in any activity, which may be harmful due to any physical limitations the student may have.  Injuries may occur since this is a physical activity.  If a student should withdraw from class, refunds will not be given on costumes.
By checking this box, I indicate that I have read and understand the liability/policy statement above.

I Give permission to use photos of my daughter's class for advertising purposes only (Web site/brochures)
YES NO

Parent/Legal Guardian name: * Date:

* = required items