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» info@dancetechstudio.com
» 208.525.3229
» 2633 E. 14th North
   Ammon, ID 83401

Registration

To register for Dance Classes, please fill out the form below, and someone will contact you to confirm your enrollment and to collect billing information.

You can also print out the enrollment form, and bring it in to our studio located at:
2633 E. 14th North
Idaho Falls, ID

{ Download Form }

Feel free to call us if you have any questions at 525-3229.

Name:
Birth date:
Grade he/she will start in the fall of 2008 School (fall 2008):
Parents name(s):
Phone:
Address:
City:
Zip:
Alternate phone numbers:
Mother:
Cell:
Work:
Employer:
Father:
Cell:
Work:
Employer:
e-mail address:
I would prefer to receive class info via e-mail including performance times, notes to parents, etc.

Where did you hear about Dance Tech?:

If living part time with other parent, please provide following:
Parents name(s):
Phone:
Address:
City:
Zip:

Student Health Status:
Please discuss any special conditions, medications, aches/pains, handicaps, allergies, etc., that we should be aware of:
Name of Doctor:
Doctor Phone #:
Emergency contact (if parent not available) Phone #:
Insurance Carrier Policy number:

Class(es) this dancer is registering for:

Release
I understand that there are inherent risks associated with dancing and related activities, and I understand it is my responsibility (and not the responsibility of Dance Tech) to maintain medical insurance for my child, , while enrolled at Dance Tech. I agree to release Dance Tech, and all Dance Tech instructors and personnel, from responsibility of personal injury, loss of property, and all other hazards that m ay occur to my child while participating in activities related in any way to their association with Dance Tech. I also authorize Dance Tech to obtain em ergency treatment for my child if they are injured or become ill during said activity.



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2633 E. 14th North, Ammon (Idaho Falls), ID 83401
208.525.3229 | info@dancetechstudio.com