LKW Dance Center Enrolment Form

Child's Name:
* First: * Last:
* Birthday: * Age:
Parent's Name:
* First: * Last:
Address:
City:
State: 
Zip Code: 
*Phone: Cell Phone:
Fax: * Email:
Tuition:
Classes:
Paid By:
* Is your child's last name different than yours:
In Case of Emergency:
Name:
Relationship:
Phone:
Does your child have any health problems:
LKW Dance Center policies:

I will not hold LKW Dance Center responsible for any injury incurred at the dance center or at any dance related activities outside the dance center.

I have read and agree to follow all LKW Dance Center policies.