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Online Registration

Summer 2018


Summer 2018 Registration Form
Current Student New Student
Parent/Guardian
First Name Last Name
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Student Information
Student First Name Student Last Name
Birth date School
Home Address City
State Zip
Please provide any pertinent medical or disability information for your student.


Class Selection
See our class schedule for more info. If uncertain, please submit questions and we will assist you.

Tiny Tots and Jumping Jacks
Tiny Tots - Tuesday
(age 2 w/ parent participation)
Jumping Jacks - Tuesday
(age 3)

Pre Dance Classes
Pre-Dance - Tuesday
(age 4-5)
Pre-Dance - Thursday
(age 4-5)

Elementary Classes
Elementary Dance 1 - Thursday
(Grades 1-3)
Elementary Dance 2/3 - Wednesday
(grade 2-3 w/ exp)

Lower Intermediate
Lower Intermediate Ballet Lower Intermediate Tap Lower Intermediate Jazz
Beginning Modern
(grades 4+)
Hip Hop 1-2

Intermediate
Intermediate Contemporary Intermediate Ballet Intermediate Tap
Intermediate Hip Hop Intermediate Jazz Intermediate Modern

Advanced
Advanced Hip Hop Advanced Ballet Pointe
(w/ teacher permission)
Advanced Ballet/Contemporary Advanced Tap Advanced Jazz
Advanced Modern

Adult
Adult Tap 1 Adult Tap 2
Adult Jazz 1 Adult Jazz 2 Adult Contemporary

Tumbling
Beginning Tumbling Intermediate Tumbling Advanced Tumbling

Strengthening & Conditioning
Stretch & Strengthening - Monday Stretch & Strengthening - Thursday


How did you hear about us?
Newspaper Riley Festival Booth Pensy Art Fair
Website Friend Other:

Questions?


Waiver:
Please read through our studio waiver. Once finished, please check the box below to electronically sign the waiver for our studio records.
I have read through the waiver and agree to the terms and conditions listed.


You will receive an e-mail or phone call from the studio office to confirm your submission and answer your questions within 48 hours. Thank you for your interest in Wilkerson Dance Studio.