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13867 Smoketown Rd.,  Woodbridge, VA  22193   •  Phone: 703.330.6730

DeGrasse Dance Studio
13867 Smoketown Rd.
Woodbridge, VA 22193
Phone 1: 703.330.6730
Fax 1: 703.330.6506
Email: jydegrasse@comcast.net

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Forms

PLEASE COMPLETE THE APPROPRIATE FORMS AND SUBMIT TO DEGRASSE DANCE STUDIO ONLINE, BY EMAIL, BY FAX OR IN PERSON.

Phone: 703-330-6730 
Fax: 703.330.6506

If you would like to sign-up online, please complete the following form. Please also print the above pdf file so that you may complete the financial part of the agreement including payment choice and signatures.
Student's Full Name
Address
City
State
Zip Code
Email (Primary)
Home Phone
Work Phone 
Student's DOB
Bold = Required field
Parent(s) or Guardian
Parent's Place of Employment
Cell Phone
Emergency Contact Name
Emergency Contact Phone
I am in Creative Movement Package:
1
I am in Recreational Plan:
1
2
3
4
Email (Secondary)
I am in Package Plan:
1
2
3
4
I am in Adult Plan:
1
2
3
4
5
Student Email (Primary)
Student Email (Secondary)
Parent / Guardian Signature
Date
STUDENT INFO
CLASS INFORMATION
AUTHORIZATION
Online Registration
DeGrasse Dance Studio
Registration & Tuition Payment Agreement 2009 - 2010
Printable PDF
DeGrasse Dance Studio
Registration & Tuition Payment Agreement 2009 - 2010
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If you have any questions regarding our class offerings please contact us below.
Bold = Required field
Full Name
Email Address
Phone
Questions or information you would like to receive.
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