LONG ISLAND DANCE FORCE
Registration Form
REGISTRATION
Student name:
Address:
City, Zip Code:
Home Phone:
Emergency Phone:
Email Address:
Date of Birth:
Grade:
Age:
Parent/Guardian
Name(s):
How did you hear about us?
Please list any medical conditions (physical or otherwise) that LIDF should be aware of:
PREVIOUS EXPERIENCE
Type of classes taken:
Where:
Number of Years:
Are you interested in becoming a competition member:
Have you previously been a competition member?  If so, where:
Choose the classes your child is interested in: (Please check all that apply)
Tap
Jazz
Lyrical
Hip Hop
Ballet
Irish Step Dancing
Modern
Gymnastics/Acrobatics
Cheer Dance
Pre-School
Creative Movement
By electronically signing this form I am agreeing to the studio's policies and procedures.
**Please be aware registration will not be official until payment is received.**
Parent/Guardian Signature:
Date:
Social Security #:
Disclosure: All information provided on this form will be kept private and will not be shared.  It is for security purposes only.
Questions, comments, or feedback: