Jane Whitt's Dance Studio
                                                                Enrollment Form
                                                                      2012-2013
Student Name   ________________________________________________________
Address  _____________________________________________________________
City _____________________  Zip ________  Phone ____________________
Birthdate ___/___/___   Grade-Fall 2013 _______   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.