Ballet School of Glyndon

Registration Form

Please Check The Class That You Are Registering For. Please Fill Out A Form For Each Child.

____3 Year Old Ballet Class

Saturday, July 12th - Saturday, August 16^th

9am-9:30am

$45.00

____4 Year Old Ballet/Tap Combo Class

Saturday, July 12^th – Saturday, August 16^th

9:30am-10:15am

$60.00

____5 Year Old Ballet/Tap Combo Class

Saturday, July 12^th – Saturday, August 16^th

10:15am-11am

$60.00

Tuition and Registration Form(s) are due by Tuesday, July 8, 2008.

I, _______________________________ am registering my child, ________________________ for the above indicated summer dance class sponsored by Ballet School of Glyndon. My $___________ of non-refundable tuition is enclosed.

_________________________________________

Parent Signature

Child’s Name: ____________________________________

Date of Birth __________________

Parent’s Name: ______________________________________

E-Mail: ___________________________________________

Daytime Phone: _____________________________________

Evening Phone: _____________________________________

Home Address: __________________________________________

More Information Will Be Sent To You Via Mail As Camp Summer Class Start Date Approaches.

Please Check Here If We May Send This Information To Your E-mail Instead Of Via Postal Mail: ____

PLEASE MAIL PAYMENTS PAYABLE TO Reisterstown Recreation TO:

Ballet School of Glyndon

P.O. Box 767

Reisterstown, MD 21136