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Summer Class Online Registration Form

To register for dance classes, just complete the brief registration form below.

If you would like to pay by check or money order, you can download a printable version, fill it out and mail it to:

Bonnie Haney School of Dance
Townsite Center
810 4th Avenue South
Moorhead, MN 56560

* required information

View Class Schedule: Ongoing School Year | Summer

Dancer Information
Name * First Last
Address *
Street Address City State Postal / Zip Code
Home Phone * ### - ### - ####
Cell Phone ### - ### - ####
E-mail *
Age *
Birthdate * MM / DD / YYYY
Have you studied dance before?
Yes No
If so, how many years?

Ballet (# of yrs)	Tap (# of yrs)	Jazz/Hip Hop (# of yrs)
Pointe (# of yrs)	Irish (# of yrs)	Ballroom (# of yrs)
Latin (# of yrs)

Father's Information
Name First Last
Address
Street Address City State Postal / Zip Code
Workplace
Occupation
Work Phone ### - ### - ####
Home Phone ### - ### - ####
Cell Phone ### - ### - ####
E-mail
Mother's Information
Name First Last
Address
Street Address City State Postal / Zip Code
Workplace
Occupation
Work Phone ### - ### - ####
Home Phone ### - ### - ####
Cell Phone ### - ### - ####
E-mail
Emergency Contact Information

In case of emergency, who can we contact other than the parents/guardians listed above.
Name First Last
Relation
Address
Street Address City State Postal / Zip Code
Phone Number ### - ### - ####
Cell Phone ### - ### - ####
Workplace
Work Phone ### - ### - ####
Class Sign Up

Please select all the classes you are registering for.
Class 1 *
Class 2
Class 3
Class 4

Summer Class Online Registration Form

Dancer Information

Father's Information

Mother's Information

Emergency Contact Information

Class Sign Up