Registration Form

***Please print, mail and send with the registration fee of $25 (if you are a new student). Previous students may e-mail***

Parent/Guardian:______________________________________________________________________________

Address:_______________________________________________________________

______________________________________________________________________

Child 1:____________________________________     

Age:________          D.O.B. ____________          Grade:________


Classes:                Tap                Jazz                Ballet                Jazz/Hip-Hip (9+only)                Jig (HS+only)


Child 2:____________________________________

Age:________          D.O.B. ____________          Grade:________


Classes:                Tap                Jazz                Ballet                Jazz/HH (9+only)        


Child 3:____________________________________

Age:________          D.O.B. ____________          Grade:________


Classes:                Tap                Jazz                Ballet

Phone Number:

Circle Nights Preferred:                Mon                Tue                Wed                Thur

Adult Lessons: (over 18)       Tap             Jazz/HH             Ballet           Jig           Line Dancing         Couples          

                                                                                Zumba             Hula Hooping (new)


Comments/Questions:_____________________________________________________________________________

______________________________________________________________________________________________

Send to:
Nicole's School of Dance
116 Meadow Hill Rd
Manchester, ME 04351
                                                  Registration Deadline: September 1st.
                  ***There is a non-refundable registration fee of $25 for new students only***