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New Heights Theatre Dance Academy & Music Center Student Registration Form September 2009 - June 2010 Last Name: First Name: Date of Birth: Parent's Name(s): Street Address: City, State, Zip Code: Phone: E-Mail: Parent's Work Phone: In Case of Emergency Phone: Previous Training: Studio Name: City/State: Years of Training: Release: I agree to adhere to the policies and guildlines set forth by New Heights Theatre Dance Academy & Music Center (NHTDA). I understand that all photographs and images taken throughout the year are property of NHTDA and may be used for advertising or promotional purposes. Parent/Guardian signature: Date: There is a Yearly $15.00 Registration Fee per Student, $25.00 per Family (Non-Refundable) Choose from the following (Please circle below): PRE-SCHOOL DANCE, PRE-BALLET, PRE-TAP/JAZZ, INTRO TO HIP-HOP, INTRO TO LYRICAL BEGINNER BALLET, BEGINNER TAP/JAZZ, BEGINNER HIP-HOP, BEGINNER LYRICAL HIP-HOP, LYRICAL, BALLET, *POINTE, TAP/JAZZ ADULT BALLET, ADULT TAP, ADULT JAZZ BASS GUITAR, CELLO, GUITAR, MANDOLIN, VIOLIN, FLUTE, CLARINET, SAXOPHONE, TRUMPET, TROMBONE, PIANO, VOICE, OTHER INSTRUMENT (________________________________) MUSIC & MOVEMENT, MUSIC MAKERS, CHORUS, GROUP PIANO (CHILD) GROUP PIANO (ADULT), FILMMAKING, MUSICAL THEATRE, MUSIC THEORY *Enrollment in this class is by Artistic Director approval only |