MPAC CELEBRATING OUR 23rd YEAR

COME DANCE WITH US

FALL REGISTRATION FORM 2017-2018

 To ensure that all parents receive important news from MPAC, please fill out the information below.

Student's name:

Date of birth:

Age:

Parents name:

Home phone:

Address: 

 

Cell phone:

Work phone:

Email address:

Emergency contact:

Circle all that apply:

BALLET  TAP  JAZZ  HIP HOP  GYMNASTICS  LYRICAL  POINTE  MUSICAL THEATER  TUMBLE TOTS  BOYS HIP HOP

 

SOLO  DUO   TRIO

NON REFUNDABLE 15.00 REGISTRATION FEE REQUIRED 


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Milford Performing Arts Center 280A Quarry Rd
Milford Ct 06460 Tel/Fax 203-876-1733