Rhythm Dance Studio -- Registration [www.dancerhythm.com]

Print out this form and send it to Rhythm Dance Studio along with the $35.00 registration fee. Make check payable to:

RHYTHM DANCE STUDIO
120 W. Matthews Street, Matthews NC 28105

For more information please call (704) 845-5260 or email us at rhythm@webkorner.com .

Fields marked with an asterisk (*) are required.

*Date
Returning Student	Y N
*Student's First Name
*Student's Last Name
Mailing Address
City	State Zip
*Contact Parent's Name
Email Address
*Home Phone	Include area code
Work Phone	Include area code
Birth date
Grade	School
Previous dance experience
How did you hear about Rhythm?

Class Title	Day	Time

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