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Registration Type
 

Classes: A $15 registraton fee is due within two weeks of this application to reserve a place in the program.

Intensive: A$25 non-refundable deposit is due within two weeks of this application. This will reserve a place in the program for your child and will be credited toward tuition. Payment must be received in full by May 15. A $25 discount may be applied if full payment by April 15.

Send deposit to:
Wissahickon Dance Academy, 38 E. Schoolhouse La., Phila. PA 19144
215-849-7950 (phone) 1-800-849-4919 (toll free) 215-849-3117 (fax)

First Name:
Last Name
Parent's Name:
Bill To:
Address:
City
State:
Zip:
Telephone
Work Phone
Cell Phone
Emergency Phone
Email
Age:
Date of Birth:
Sex:
Male
Height:
Weight:
Previous Dance Teacher:
Previous School:
Housing Needed:
Class, Day, and Time: (Winter registrants only)
Ballet Background:
Comments:
 
 

38 East Schoolhouse Lane, Philadelphia, PA 19144

telephone: (215)-849-7950    fax: (215)-849-3117
toll free: 1-800-849-4919
email: wissahickondance@verizon.net