Dee Dots Dance Academy and DOJO Karate Registration

2011-2012 Fall Registration Form

* No Fundraisers * No Recital Fee * No Contracts *

Registration fee is $25.00 for the first Child and $20.00 for each additional child. Type into form fields & print out the Page. Return to Dee Dots with your payment.

Student Name(s)
Address
City
State		Zip Code
Date of Birth
Parents Name(s)
Phone number
Work Phone Number
Cell #
Email Address

Emergency Contact
Emergency Number
Allergies/ Medical

Class Choice 1
Class Choice 2

To Print: Click here or Select File/ Print from your Browser Menu

> Return Form & Payment to Dee Dots via mail or in person.

Registration Fee is Non-refundable.