Registration Form

(* Required Fields)

Student First Name*
Last Name*
Birthdate*
Age
Student Cell Phone
Parent First Name*
Last Name*
Street Address
City
State
Zip Code
E-mail Address*
Home Telephone
Work Telephone
Mom Cell Phone
Dad Cell Phone
Dad Cell Phone



Person Responsible for Billing (If different from above)

Parent First Name
Last Name
Street Address
City
State
Zip Code
Medical restrictions:
Comments:



Class Registration

Class 1
Day
Time
Class 2
Day
Time
Class 3
Day
Time
Class 4
Day
Time
Class 5
Day
Time
Class 6
Day
Time


Payment Plan  Full 2 Pay 5 Pay


How did you hear about us?  Yellow Pages Newspaper Internet Other

Required to submit this form :

Special Offers

Boys Free – Start Date Sept 10 End Date October 24
Family Discount SAME AS ABOVE

Contact us

Bonnie Williams Dance Studio
4186 Mt. Carmel-Tobasco Rd.,
Cincinnati, Ohio 45255
Phone: 513-528-5098
E-mail: dancerbwds@yahoo.com


WHERE DANCE IS ALWAYS FUN!

Call today to register!

Copyright © 2009 Bonnie Williams Dance Studio. All Rights Reserved.

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