2019-2020 Dreams Studio Registration
 
Student’s Name _____________________________________________________ Birthdate __________________________ Age_________________
 
Address ________________________________________________________ City _____________________ State_______________ Zip ____________
 
Parent’s/ Guardian’s Names ____________________________________________________ Email _________________________________________
 
Home Phone # _______________________________ Cell # _______________________________________ Yes ______ I receive Text Messages
 
Mother's/ Guardian's Place of Employment ______________________________________________ Work # ______________________________

Father's/ Guardian's Place of Employment ______________________________________________ Work # ______________________________

Emergency Contact __________________________________________________ Phone Number _________________________________________
 
Relationship to Student ___________________________________________________   Allergies _________________________________________
 
*I hereby acknowledge that: I am enrolling in a year-long performance-based class. I will attend all classes,
unless not medically able to or prior notice is given. I will treat my classmates, Mrs. Kiel and myself with respect!
**I hereby acknowledge that: Dreams Studio, LLC,  Elkhorn Area School District, Lakeland Players Performing Arts Theatre, 
Jennifer Kiel and all instructors disclaim liability for theft, property loss, damage or personal injury sustained on the premises
and arising out of class. My student has no medical or physical condition in which dance would be against his or her
doctor’s recommendation.  I also release any photos that would be taken for the promotion of Dreams Studio.

​Please check ALL that apply 
Interested in Competitions? YES _____  NO ______
Class Interest: Combo _____    Lyrical _____    Hip Hop _____    Musical Theatre _____    Pre-Pointe _____    Pointe _____    Dreamettes _____ 

Previous Dance, Voice or Theatre experience __________________________________________________________________________________________________
                                                                               
Student Signature ______________________________________________________    Parent Signature ___________________________________________________
 
*Please include $30.00 registration and Quarterly fee to reserve your child's class. 
Online payments available or mail registration and fee to
Dreams Studio
 PO Box 625
 Elkhorn, WI 53121