Iibada Dance Company

Class Registration

Note: All fees are non-refundale
Student Registration Fee: $25.00

Class Fee: $12.00 per class
(Paid in 12 week sessions = $144.00 )

First Name
Last Name
E-mail
Birth Date
Address
City
State
Zip
Phone
School
Grade Level
Parent or Guardian
Parent or Guardiian Address
Parent or Guardiian Work Phone
Parent or Guardiian Mobile phone
Dance Experience