PLEASE NOTE:
We have moved. Our new location is at 350 Lexington Ave. Mt. Kisco, NY (Click here to see a map)

The classes you register for below, will be taken at our new location in Mt. Kisco.

Student Name:		Date of Birth:	Age:
Address:
City:		State:	Zip:
Home Phone #:
Cell Phone #:
Work Phone #:
Parent(s)/ Guardian Name:		Email:
Emergency Contact (Name):		Phone #:
Which class(es) are you interested in? Monday 3:45 - 4:45 Jazz (ages 8-9) 4:45 - 5:30 Ballet (ages 8-9) 5:30 - 6:30 Hip Hop (ages 8-10) 6:30 - 7:30 Hip Hop (ages 11-12) 7:30 - 8:30 Hip Hop (Teen) Tuesday 1:00 - 1:45 Pre Ballet (ages 3-4) 1:45 - 2:30 Ballet (ages 4-5) 3:30 - 4:15 Ballet (ages 6-7) 4:15 - 5:00 Jazz/Hip Hop (ages 6-7) 7:00 - 8:00 Jazz/Musical Theater (Teen) 8:00 - 9:00 Lyrical (Teen) Wednesday 3:30 - 4:15 Pre Ballet (ages 4-5) 4:15 - 5:00 Jazz/Hip Hop (ages 4-5) 5:00 - 6:00 Ballet (Pre-Teen Troupe) 6:00 - 7:00 Lyrical/Jazz (Pre-Teen Troupe) Thursday 3:45 - 4:45 Jazz (ages 8-9) 4:30 - 5:30 Hip Hop (ages 8-10) 5:30 - 6:30 Hip Hop (ages 11-12) 6:30 - 7:30 Hip Hop (Pre-Teen/Teen) 7:30 - 8:30 Hip Hop (Teen) Friday 3:45 - 4:45 Jazz (ages 8-9) 5:00 - 6:00 Master Class (ages 11-12) 5:30 - 6:30 Master Class (Small Fry) 7:00 - 8:00 Master Class (Juniors) 7:00 - 8:00 Master Class (Teen/Senior) Saturday 10:00 - 10:45 Pre Ballet (ages 2 1/2-4) 10:00 - 10:45 Pre Ballet (ages 3-4) 10:45 - 11:30 Ballet (ages 5-6 beginner) 10:45 - 11:30 Ballet (ages 5-6) 10:00 - 11:00 Jazz/Tap (ages 5-6) 11:00 - 12:00 Jazz/Tap (ages 7-8)		Bianca
What dance experience has your child had?
If your child has any health problems or learning disabilities we need to be aware of, please explain:
Please read our Studio Policies: I have read and agree to abide by the studio policies of Westchester Dance Academy.We sometimes use candid photos of students in our brochures, publicity releases, and website. Do we have your permission to use your child's photo? YES NO
Parent/Guardian's Name:
Date: