PLEASE COMPLETE AND RETURN BEFORE MAY 3lst WITH $15.00 FEE. THE FEE WILL BE $18.00 AFTER MAY 31st FOR CURRENT STUDENTS. REGISTRATION FEE WILL REMAIN $15.00 FOR NEW STUDENTS. STUDENT’S NAME ____________________________________________________________ AGE _____________________________ PARENT'S NAME _____________________________________________________________ PHONE ___________________________ ADDRESS ___________________________________________________________________ CITY/ZIP __________________________________________________________________ CLASS DAY AND TIME 1st CHOICE ______________________ 2nd CHOICE ______________________ CLASS DAY AND TIME 1st CHOICE ______________________ 2nd CHOICE ______________________ LIST ADDITIONAL CLASSES BY DAY AND TIME ___________________________________ ___________________________________________________________________________ EMAIL ADDRESS _____________________________________________________________ WOULD YOU LIKE TO HEAR ABOUT FUTURE PERFORMANCES OF THE CUYAHOGA VALLEY YOUTH BALLET? YES/NO RETURN FORMS TO: EXCELLENCE IN DANCE-MIA KLINGER WELCH 2315 STATE ROAD, CIRCLE CUYAHOGA FALLS, OHIO 44223