Register Here for Dance Classes

Just click on the Registration Form to sign up for dance classes!




You can fill in the form right on your computer. When you've completed the form, either save the document or print out a hardcopy on your printer.

Then you can either fax it to the studio at 508-867-0950 or email it to us at bettygundersendance@gmail.com.



You can also mail it to:
Betty Gundersen Studio of Dance
PO Box 1141
West Brookfield, MA 01585


dance class schedule
If you have any questions, or would like to register by phone/fax, please contact the studio and we'll be happy to help!

Student Information
Name: *
Street Address: *
City, State Zip Code: *
Date of Birth:
School:
Grade:
Home Phone:
Cell Phone:
Email:
Physical or Health Restrictions (if any):
Previous Dance School Affiliation:
Years of Study:
Account Information
Mother's Name:
Work or Cell Phone:  
Father's Name:
Work or Cell Phone:                             
 
Email Address:
Emergency Contact:
Relationship:
Phone:
  Billing Address Same as Above?


Billing Information
Name:
Mailing Address:
City, State Zip Code:
How should we contact you Phone
 to confirm this registration? Email
Any Questions or Comments about this Registration:


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