Which location are you interested in registering your children? * Kenner Studio Mandeville Studio Destrehan Studio What is your name? * What is your Telephone Number? * What is your street address? * Your City and State? * What is your Zip Code * How many children do you have wanting to take lessons? 123 What is the first childs name? How old are they? Total years of dance? Which classes are they interested in? Tap & Ballet ages 2 1/2 - 6 Tap & Jazz ages 6 and up Beginner Lyrical starts at age 7 Beginner Ballet starts at age 7 Beginner Jazz / Hip Hop starts at age 7 Intermediate Ballet Intermediate Jazz and Hip Hop Intermediate Hip Hop Advanced Lyrical Advanced Ballet Advanced Jazz Advanced Jazz and Tap Dance Team Prep Class 12 & Up Competition Other What is the second childs name? How old are they? Total Year of Dance? Which classes are they interested in? Tap & Ballet ages 2 1/2 - 6 Tap & Jazz ages 6 and up Beginner Lyrical starts at age 7 Beginner Ballet starts at age 7 Beginner Jazz / Hip Hop starts at age 7 Intermediate Ballet Intermediate Jazz and Hip Hop Intermediate Hip Hop Advanced Lyrical Advanced Ballet Advanced Jazz Advanced Jazz and Tap Dance Team Prep Class 12 & Up Competition Other What is the third childs name?   How old are they? Total Year of Dance? Which classes are they interested in? Tap & Ballet ages 2 1/2 - 6 Tap & Jazz ages 6 and up Beginner Lyrical starts at age 7 Beginner Ballet starts at age 7 Beginner Jazz / Hip Hop starts at age 7 Intermediate Ballet Intermediate Jazz and Hip Hop Intermediate Hip Hop Advanced Lyrical Advanced Ballet Advanced Jazz Advanced Jazz and Tap Dance Team Prep Class 12 & Up Competition Other How did you hear about us? Friend that goes to Kellis Kreative Dance Drove by and saw the studio Family Member Flyer Ad or Yellow Pages Web Site Other E-mail Address: *   If other.. How? Enter your comments or questions in the space provided Have you been a student of Kellis Kreative Dance? Yes No Verification Code:   Enter Verification Code: *   * Required