DANCE EXPRESSIONS

23730 Maple Valley HWY SE, Maple Valley, WA 98038

2019/2020 REGISTRATION FORM

SEPTEMBER 9TH-JUNE 21ST
DANCER NAME:__________________ BIRTHDATE:_________

PARENT/GUARDIAN:____________________________

MAILING ADDRESS:_____________________________

CITY:____________ZIPCODE:_________PHONE#:___________

EMAIL #1:________________ EMAIL #2___________________

EMERGENCY CONTACT:_______________________________

LIST DANCE CLASSES BELOW

1._______________ 2._______________ 3.________________

4._______________ 5._______________ 6.________________

7._______________ 8.________________ 9.________________

DANCER’S PHOTOS MAY BE PUBLISHED TO THE STUDIO WEBSITE AND OTHER MEDIA
OUTLETS, BY SIGNING BELOW YOU GIVE DANCE EXPRESSIONS PERMISSION TO PUBLISH
YOUR DANCER’S PHOTOS.

SIGNATURE:_________________________ DATE:______________

P 425-432-9685 E MVDANCEXPRESSIONS@GMAIL.COM