FALL 2008
LKD STUDIO REGISTRATION FORM
Dancer Information: __New Student __Returning student
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Dancer’s Name
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Date of Birth School Grade
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Dancer’s Address City/State/Zip
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Home Phone Email Address
Parent/Guardian Information:
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Parent/Guardian Name Cell Phone-Email Address
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Parent/Guardian Address (if different from dancer) City/State/Zip
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Parent/Guardian Name Cell Phone-Email Address
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Parent/Guardian Address (if different from dancer) City/State/Zip
Class Information:
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Class Name Day Time
Payment Information: Please call to make a credit card payment by phone. Checks payable to Luna Kids Dance.
o for information about scholarships click: Scholarship Application Form
o $50 NON-REFUNDABLE deposit for Fall 2008 Session or
o Full Payment for Fall 2008 Session
Class Tuition $180 # of classes____x $180=$________
Discount (-30% for 2classes/week, call for info re: full year discount) -$108 Registration Fee (annual fee)$25 +$25
T-shirt $15 size ______color_________ # of t-shirts____x $15= $________
Total……………………………………………………………………………$________
o I understand that the full balance is due by September 10 and all scholarship request letters are due in the Luna office by September 1.
Signature_________________________________________________________
