Lisa's Dance Studio

                       Class Registration


We are now accepting Registration!

If you have any questions,
please call the Dance Studio at


To register, please complete the form below and click the submit button at the bottom.  After submitting your form, you will receive the response,
"Your form is being processed". 

* = Required to submit Registration Form

Student's Name: *

Date of Birth: * Age as of September 1st: *

Responsible Parent or Guardian: *

Street Address: *

Town/City: * Zip: *

Home Phone (with area code):

Parent(s) Cell Phone Number: *

Parents(s) Work Phone Number:

Parent(s) Email address: *

Repeat Email address:

In case of Emergency

Name: Phone: Relation:

Student's Cell Phone Number (if available):

Student's Email Address (if available):

Classes requested: (list subject and DAY and TIME of Class)
Class 1: *

Class 2:

Class 3:

Class 4:

Class 5:

Class 6:

Class 7:

Payment method *must select one of the options below
    Choose Option 1, 2, or 3 / Click or touch the circle to the left of your choice

  Option 1: AUTOMATICALLY withdraw Monthly Tuition and other Studio Fees
                         from my debit/credit card (Visa, MasterCard, Discover)
-Tuition will be Automatically Withdrawn on the first of each month starting in October.
Tuition for September is due when Registering. 
            -At the bottom of this section is a list of all Studio Fees and when they are due.
            -Because the month of June is especially busy preparing for the Recitals,
             Tuition for June will be withdrawn in May.
                  * The Studio will contact you for your credit/debit card information.
                  * If you were enrolled on Automatic Withdrawal last Dance Year,
                     would you like us to use the card on file?

               Yes, use the card on file.
               No, do not use card on file.  Contact me for new card information.

  Option 2: Will pay tuition (cash only) in 2 payments
       Tuition for September is due when Registering along with the Registration fee (we will contact you).
        Tuition for October through January is due by October 7th.
        Tuition for February through June is due by February 7th.

  Option 3: Pay Tuition for the year by Credit Card, Debit Card, or Cash.

Below is a list of Studio Fees and when they are due:

* Due when you Register for Classes - Registration Fee:  $30.00 (paid once a year, when registering).
* November 10th – Recital Costume(s)
The Toddler (age 2), Pre-School (ages 3&4), and KinderDance (ages 5&6) Classes
       will have one costume.  
     - Level 1, Level 1.5, Level 2, and Level 2.5 Ballet, Tap, and Jazz - will
 wear the same costume
       for Tap and Jazz and have  a different costume for Ballet.  
     - All other classes will have one costume. 
     - The cost per costume is $50.00-$75.00.

* February 1st  – Recital Fee: Recital Trophy, Recital DVD: $53.00


Years of Previous Training
Ballet:   Tap:   Jazz:   Streetdance:   Pointe:   Other:

* IMPORTANT for Recital Trophies (5, 10, & 15 Year Awards)
This will be my * year at Lisa's Dance Studio.

How did you hear about Lisa's Dance Studio? *

Does your child have any medical problems or is she/he limited in any way?

Do we have permission to use your child's photograph or video for advertising purposes?
* Yes        No    (must select Yes or No)

By typing my name below:

I understand it is my responsiblity to read the Studio's Policies (listed on the website) before my child's first lesson.  I understand that Enrollment in the Studio Requires Acceptance of the Studio's Policies.  

Type full name of person completing form (E-Signature):  


* = Required items



Lisa's Dance Studio | 101 Adams St, Quincy, MA 02169 | (617) 471-5678 |

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