Reg Info 2

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?

What is the first child's 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 child's 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 child's 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 Kelli's Kreative Dance Drove by and saw the studio Family Member Flyer Ad or Yellow Pages Web Site Other
If other.. How?

E-mail Address: *
Enter your comments or questions in the space provided

Have you been a student of Kelli's Kreative Dance?
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Verification Code:
Enter Verification Code: * Thank you for your interest in Kelli's Kreative Dance. Once you click the submit button you will be taken back to our Home Page. Please check your email for your verification that we received your registration.


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