Jane Whitt's Dance Studio
                                                                Enrollment Form
Student Name   _____________________________________________________________________
Address  __________________________________________________________________________
City _________________________           Zip ______________                   Phone ____________________
Birthdate ______/_______/_______          Grade-Fall 2014 _______                School ___________________
Parent/Guardian Name  __________________________________________________
Best Phone _____________________            Email_______________ ____________________________
A non-refundable $20.00 fee is due at time of enrollment.  Once this form is received at the studio, you will be given the Enrollment Contract for your child which contains specific information regarding class times and fees.