Excell Dance 2010 Pre-Registration

The purpose of pre-registration is to help us plan and organize our class schedules. Class placement is guaranteed for all dancers currently enrolled at Excell Dance. Acceptance of pre-registration does not guarantee placement in class. We will send notifications early September as to whether we are able to place your dancer; registration fees will be collected at that time.

Parent Information
First Name: Last Name:
Address:
City: State: Zip:
Phone (Home): Mom cell: Dad cell:
Phone (Other): Mom work: Dad work:
Email: Email (Work): Email (Other):
How did you hear about Excell Dance?:

    How many dancers are you pre-registering?    


Dancer Information

     Check if currently enrolled in Excell Dance classes
First Name: Last Name:
Birthdate: Age:
School: Grade:
Email: Cell Phone:
Desired class:
Previous dance experience:
Any special needs?: