Dance Steps Studio, Inc.

Fields marked with an asterisk(*) are required.
If you have any questions about this, please call 734-429-5522
or email dancesteps@comcast.net.

Download a printable version of the registration form here. Get Adobe Acrobat Reader here.
I have read and agree to Dance Steps Studio, Inc.'s rules, policies and payment schedule. I authorize Dance Steps Studio, Inc. to instruct my child in the fine art of dance and therefore will not hold Dance Steps Studio, Inc., it's employees and/or Harrison Properties, LLC or Saline Properties, LLC liable for any injury while on the premises or due to dance instruction.

Parent Information
Billing Name *
Address *
City *
Zip Code *
Home Phone *
Providing an email address signs you up for the Dance Steps mailing list, providing newsletters, updates, cancellations, etc., and is used exclusively for Dance Steps purposes.
E-Mail
Parent 1
Cell Phone
Work Phone
Parent 2
Cell Phone
Work Phone
How did you learn about our studio?
Emergency Contacts
Name
Phone
Name
Phone
Student Information
Name *
Address
City
Zip Code
Date of Birth *
E-Mail
Health Info

Classes	Studio	Day	Time	Tuition
				$
				$
				$
				$
				$

Secure Credit Card Payment Information
Name as it appears on card	VISA/Mastercard Number	Expiration Date (mm/yy)	Vcode (last three digits on back of card)

By clicking the Submit button, I agree that my credit card will be charged a total of $ A convenience fee of $2.00 will now be added for all credit card transactions.