Grosse Ile Academy
Family Registration Form

Contact Information:
Parent's Name:
Address:
City:
State: Zip:
Phone: Cell Phone:
email:
Comment:
Dancer Information:
Dancer
Names
Date of Birth
Age
1.
2.
3.
Subjects: Indicate the Subjects you would like to register for with an X or dancer's number...
Ballet
Cecchetti
Level*
Pointe
Lyrical
Musical Theater
HipHop
Jazz
Modern
Hawaiian
Tap
Gym
* Indicate current Cecchetti Level: I, II, III, IV, V, VI, VII, Diploma
Days and Times: Indicate the best day and time for your class choice. Use Numbers 1 through 4 to rank your choices...
Any Day
12:30 or 1:00
After 4 PM
After 6 PM
Monday Tuesday Wednesday Thursday

Registration Fee: $20.00 per family. Indicate your preferred method of payment.

Your request will be emailed to us when you press the send button.