REGISTER FOR SUMMER | Quincy, MA | tap, jazz, ballet, hip hop, dance teams, pointe

To register for summer classes, please complete the form below and click the submit button at the bottom. For the ENTIRE summer schedule of classes, click "CLASSES" (above, top left) and then click on "Summer Schedule".

Student's Name: *

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

Reponsible Parent or Guardian: *

Street Address:

Town/City: Zip:

Home Phone (with area code):

Parent(s) Cell Phone Number: *

Parent(s) Work Phone Number:

Parent(s) Email address: *

In case of Emergency

Name: Phone: Relation:

Student's Cell Phone Number (if available):

Student's Email Address (if available):

For the Schedule of Summer Classes, please check the "Summer Schedule" listed under "CLASSES".

Classes will be added or dropped due to demand.
If you have any questions, please call us at 617-471-5678.

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

Class 2:

Class 3:

Class 4:

Class 5:

Class 6:

Class 7:

The Studio will contact you for your credit/debit card information.

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

How did you hear about Lisa's Dance Studio?

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

Full name of person completing form: * Date: *

* = Required items