Print and mail to:
Fort Parks & Recreation, 30 N. Water St. W., Fort Atkinson, WI 53538
Print and mail to:
Fort Parks & Recreation, 30 N. Water St. W., Fort Atkinson, WI 53538
Returning Student (spring/fall
07/08)
New Student
(including Summer 2007 Program)
Dancers Last Name (please print)
Address_________________________________ How many years in
Program? ____
City ___________________________________________Zip ____________________
Home Phone # (_____) ______-__________ 2nd Phone # (______)
______-_________
Parent(s) Names ________________________________________________________
E-mail address: _________________________________________________________
| Age by Sept. 1, 07 | First Name | Class Name | Day | Time | Instructor | Fee |
| $ | ||||||
| $ | ||||||
| $ | ||||||
| $ |
|
Subtotal |
$ |
|
BE SURE TO CALL FOR AVAILABILITY OF CLASS TIME AND INSTRUCTOR If 2 installments - 1/2 of subtotal |
$ |
|
MAKE CHECKS PAYABLE TO: CITY OF FORT ATKINSON Costume Deposit - $25 per class |
$ |
|
Total Amount Due |
$ |
Office Use Only
Amount Due -
$_____________________
2nd payment due by January 11, 2008
Amount Paid - $
2nd payment - $
Date Paid: _________ Check#/Cash:
By _______
Date Paid: _________ Check#/Cash:
By _______
Remainder due $___________________________