The Lily Schrager Program In Creative Dance
CREATIVE DANCE REGISTRATION FORM

PLEASE PRINT

 
CHILD'S NAME(S)
 

AGE(S)

 

STREET ADDRESS

 

CITY/STATE/ZIP

 

TELEPHONE                                              CELL PHONE

 

PARENT'S NAME

 

PARENT'S SIGNATURE

 

AMOUNT ENCLOSED

FEE: $350.00
Including a $35.00 non-refundable registration fee.

Multiple students from one family pay only one registration fee.
No refunds after the fourth class.
Registration and payments are due in full before students start classes.

Print this page, fill out clearly, and mail with check  payable to:

Rutgers University

Creative Dance
Rutgers University
Department of Dance
85 George Street
New Brunswick, NJ 08901