Aimee’s Academy of Dance 2017-2018 Registration Form Aimee’s Academy of Dance

Name ______Age______114 South Main Street Address/Town______Parents’ Names ______Seymour, CT 06483 Phone ______Cell ______Student’s Birthday ______(203) 463-8243 Please select the class(es) you would like to take. There is a non-refundable $20.00 registration fee due. Aimeesacademy.com 45 Minute Tap/Ballet Combination (Ages 3-5) $500.00 ______

1 Hour Tap/Ballet Combination (Ages 5-11) $550.00 ______

45 Minute Ballet (Ages 13 and up) $550.00 ______

45 Minute Tap (Ages 13 and up) $550.00 ______

45 Minute Jazz Class (Ages 5 and up) $550.00 ______

45 Minute Lyrical Class (Ages 7 and up) $550.00 ______

45 Minute Hip Hop Class (Ages 5 and up) $550.00 ______

45 Hippity Hop or Hippity Hop and Roll (Ages 4-6)-circle one $550.00 ______

45 Minute Tumbling Class (Ages 5 and up) $550.00 ______

½ Hour Baby Ballerina (Ages 2-3) $400.00 ______

½ Hour Ribbon (Ages 7 and up) $400.00 ______

½ Hour Baton (Ages 7 and up) $400.00 ______

45 Minute Contemporary (Ages 12 and up) 550.00 ______

Ambassadors free with class ____

Competition (By invitation Only) ______Please circle or highlight the classes you will be taking (Ballet, Tap and Lyrical or jazz are required as well as required competition classes): tap ballet jazz lyrical contemporary hiphop baton ribbon tumbling stretch technique Live, Love, DANCE!! I understand that, as with any physical activity, injuries and even fatalities can occur and will not hold Aimee’s Academy of Dance responsible. I also agree that by signing up for the 2017-2018 that I am Follow us on facebook, Instagram and twitter! financially responsible for the entire dance year, September through June. PARENT’S SIGNATURE______Day of the week & time requested ______