Class Registration Form

CLASS REGISTRATION FORM
This form hold your place in class.

Name _______________________________________ Fall School Grade __________ Birth Date __________________________________

Name _______________________________________ Fall School Grade __________ Birth Date __________________________________

Mailing Address _______________________________________ Email: ____________________________________

Parent/Guardian _______________________________________ Phone:____________________________________

I am pre-registering for fall classes in order to secure my participation. I understand that I will need to attend the Open
House on August 26 to finalize registration and receive my welcome packet and orientation.

I’ve enclosed my non-refundable registration fee (Returning students are $25 and new students are $35)*
* For new students enrolling with a returning sibling, use the $25 rate (Family maximum is 3 fees)
* For returning students, enroll by June 30th and receive $10 discount per student per student (maximum of 3)

Registration Fees: # of Students ______ @ $ __________ = Total Enclosed $ __________

To hold a spot in class, return this form and the first month’s tuition as soon as possible but no later than August 30th.
After that date, contact Monica Gingerich at 260-632-5768 to inquire about class space availability.
Print this form and send it, along with check to:

The River Dance Co.
21412 Ehle Road
Woodburn, IN 46797

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