Registration Form

Student Name_____________________________________________________________

Preferred Name__________________________ Birthdate __________________________

Mother's Name ___________________________ phone # __________________________

Father's Name ___________________________ Phone # __________________________

Mailing Address ___________________________________________________________

City ____________________________________ Zip Code _________________________

Email Address _____________________________________________________________

Class Registering for __________________________________________

  __________________________________________
 
  __________________________________________

$30 costume deposit per class* (1 hour class for prek-5th grade, tap/jazz $30, lyrical $30, hip hop $30 for 6th grade and older) *NO COSTUME FEE FOR SUMMER CLASSES AND CAMPS

Please mail to: Marla's School of Dance
  1015 16th Ave NW
  Surfside Beach, SC 29575

You will receive an email confirmation when we have received your payment and registered your child.

All classes fill on a 1st come 1st serve basis