Student's First Name       Student's Last Name

Date of Birth     Parent's Name

Street Address 1      Street Address 2

City      State MD PA VA        Zip Code

Home Phone      Work Phone      

Cell Phone      Email Address

Please select from the list below the class(es) for which you are registering this student. 

CLASS 1 None MONDAY 10:00-10:45am Tiny Tots MONDAY 10:45-11:30am Fairytale Ballet TUESDAY 5:30-6:15pm Tap I TUESDAY 5:15-6:15pm Ballet I Teen TUESDAY 7:00-7:45pm Hip Hop I WEDNESDAY 4:45-5:30pm Ballet I WEDNESDAY 4:45-5:30pm Modern II WEDNESDAY 5:30-6:30pm Ballet II WEDNESDAY 5:30-6:30pm Jazz II THURSDAY 4:45-5:30pm Tiny Tots THURSDAY 5:30-6:15pm Fairytale Ballet THURSDAY 5:30-6:30pm Hip Hop II PRINCESS CAMP July 7-10, 9:30-11:30am BROADWAY DAZE CAMP July 7-10, 12:30-2:30pm  

CLASS 2 None MONDAY 10:00-10:45am Tiny Tots MONDAY 10:45-11:30am Fairytale Ballet TUESDAY 5:30-6:15pm Tap I TUESDAY 5:15-6:15pm Ballet I Teen TUESDAY 7:00-7:45pm Hip Hop I WEDNESDAY 4:45-5:30pm Ballet I WEDNESDAY 4:45-5:30pm Modern II WEDNESDAY 5:30-6:30pm Ballet II WEDNESDAY 5:30-6:30pm Jazz II THURSDAY 4:45-5:30pm Tiny Tots THURSDAY 5:30-6:15pm Fairytale Ballet THURSDAY 5:30-6:30pm Hip Hop II PRINCESS CAMP July 7-10, 9:30-11:30am BROADWAY DAZE CAMP July 7-10, 12:30-2:30pm

CLASS 3 None MONDAY 10:00-10:45am Tiny Tots MONDAY 10:45-11:30am Fairytale Ballet TUESDAY 5:30-6:15pm Tap I TUESDAY 5:15-6:15pm Ballet I Teen TUESDAY 7:00-7:45pm Hip Hop I WEDNESDAY 4:45-5:30pm Ballet I WEDNESDAY 4:45-5:30pm Modern II WEDNESDAY 5:30-6:30pm Ballet II WEDNESDAY 5:30-6:30pm Jazz II THURSDAY 4:45-5:30pm Tiny Tots THURSDAY 5:30-6:15pm Fairytale Ballet THURSDAY 5:30-6:30pm Hip Hop II PRINCESS CAMP July 7-10, 9:30-11:30am BROADWAY DAZE CAMP July 7-10, 12:30-2:30pm

CLASS 4 None MONDAY 10:00-10:45am Tiny Tots MONDAY 10:45-11:30am Fairytale Ballet TUESDAY 5:30-6:15pm Tap I TUESDAY 5:15-6:15pm Ballet I Teen TUESDAY 7:00-7:45pm Hip Hop I WEDNESDAY 4:45-5:30pm Ballet I WEDNESDAY 4:45-5:30pm Modern II WEDNESDAY 5:30-6:30pm Ballet II WEDNESDAY 5:30-6:30pm Jazz II THURSDAY 4:45-5:30pm Tiny Tots THURSDAY 5:30-6:15pm Fairytale Ballet THURSDAY 5:30-6:30pm Hip Hop II PRINCESS CAMP July 7-10, 9:30-11:30am BROADWAY DAZE CAMP July 7-10, 12:30-2:30pm

SUMMER SESSION COST AND TERMS

CASH OR CHECK ONLY, Please.

$20.00 Registration fee applies.  ($12 for returning students)
Please Note: Registration Fees are non-refundanble

6 classes for $55 with the Live to Dance Membership Card

OR Drop-In Rate:  $10 / class

The undersigned, for him(her)self and / or as the parent or guardian of the student named above (individually and collectively, the Student) assumes the sole risk of injury, accident, death, loss, cost or damage to his or her person or property which might arise from the use of Taneytown Dance Center's services and facilities, or participation in any dance / exercise course program, including the matter relating to any preexisting physical condition or impairment. The Student, his / her heirs, personal representatives, executors, employees, servants, and agents from all claims, demands, injuries, damages, actions or causes of action and from all acts of passive negligence on the part of Taneytown Dance Center, its servants, instructors, agents or employees. The Student further certifies that he or she is in good physical health and is able to undertake and engage in the physical exercise or sports activities in which he or she chooses to participate, including participation in any dance / exercise course or program.

Yes, I accept the terms above (equates to signature of Student or Parent / Guardian, if minor)