Please complete
and return form with $20.00 in person fee or $30.00 video fee.
Payable to: PDT Studio
Address: 116 Rockingham Row, Princeton, NJ 08540
Circle one:
Auditioning by VIDEO or IN PERSON.
Circle one: Interested in DAY or BOARDING STUDENT.
Date:
| Student: | Date of Birth: | Age: (As of June 1, 2008) | |
| Height: | Weight: | ||
| Address: | City: | State: | Zip Code: |
| Day Time Phone: | Evening Phone: | Cell Phone: | |
| EMAIL: | |||
| Current Dance School: |
Classes per week: | Years of Training: | |
| Summer programs you have attended in the past two years: | |||
| Parent or Legal Guardian: | |||
| Home Address (if different from above): | |||
| Parent or Legal Guardian emergency phone number (cell): | |||
Please attach a photograph in first arabesque.
I certify that my child is in good health and capable of participating in all activities and classes. I hereby release and forever discharge PDT Studio of and from any and all claims, demands, rights or cause of action of whatsoever kind or nature, arising from, or by reason of, any and all known or unknown, foreseen or unforeseen bodily or personal injuries and the consequences thereof.
Signature of
Parent of Guardian:
Date:
TUITION PAID IS NON-REFUNDABLE
PDT use only:
|
Number:
|
Comments:
|