Registration Form

FootNotes Music & Dance Studio
Fall classes start Thurs Sept 11th. Enroll Today!

Thank you for filling out the FootNotes Registration form below. All required fields are important for a complete registration. IMPORTANT INFORMATION: If you decide to register and make payment for a class, a $10 registration fee is non-refundable if you withdraw from a class before or during the start of classes. (The registration fee is included in tuition.)
The field marked with (*) are required fields.
*	Student's Name:
*	Date of Birth:
*	Address, City, Zip:
*	Home Phone:
	Cell or Work Phone:
	Email address:
*	Parent's Name(s):
*	Class Choice:
	Discount Code: (located in the "Links & Extras" section)
*	Final Total:
*	How did you hear about FootNotes?
	Referred by:
*	I understand I have full responsibility for my child, for the safety of myself and any other participates, and shall be taken at my own risk. FootNotes is not responsible for any injuries causes while participating in classes. I also agree to notify FootNotes should any information on this form change.	Yes, I understand and agree No, I do not agree
*	I give permission for photographs to be taken of my child in class and permission for the photos to be used for promotional fliers, advertisements, and on our studio website.	Yes No