Michele's Dance Center - Registration Form
Dancer's Name	First	Last
	Birthday	Phone Number
	Age	Grade
Address	street
	city , state zip
	email address
Would you prefer paper handouts?
	Mom's Name	Dad's Name
	Mom's Phone	Dad's Phone
Do you have any concerns ? (medical/Allergies/Behavioral)
	Returning Student?	Previous Dance Training?
	How did you hear about us?
What Class(es)?