Registration Form

Student's Name:
Date of Birth:
Age:
Parents' Names:
Street Address:
City, State, Zip Code:
Home Phone #:
Cell Phone #:
Email Address:
Class Title:
Days:
Hours:
Date:
Total Fees Enclosed:	$
New Students Only - Previous Training   How did you hear of The Ballet Class?

Please fill out this form, print, and mail with a check for the full amount of tuition made out to Ballet Class of Rye, LLC.

Mail to: The Ballet Class, P.O. Box 252, Rye, NY 10580.