Registration Form

If your child is a current student at the Kelly School of Dance, please do not use this form; please call the office to confirm your class choice for the fall term.

To ensure your student’s place is reserved, a registration fee of $20.00 per student is required. Please complete the form and send a check to the address below, or drop one off at the studio.

Kelly School of Dance
1932 Wise Drive
Dothan, AL 36303

If you are registering more than one student this form must be completed for each student.

Registration

Student’s Name *

Parent/Guardian *

Address *

City

State

Zip Code *

Home Phone *

Work Phone

Cell Phone

The best number to reach me at is *

Home Phone

Work Phone

Cell Phone

Date of Birth *

Previous Dance Experience

If “Yes”; years, style, and studio where studied

The Kelly School of Dance – Dothan, Alabama :: Offering instruction in ballet, tap, jazz and hip-hop dance styles.

Registration Form