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Terry Fyke
Stuido of Dance
& Arts LLC

tfsdarts@hotmail.com
www.tfs4dance.com

3721 Scottsville Rd.
Scottsville, NY 14456

t: 585.889.5920

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To Register for Classes:

Please fill out a printable registration form and mail payment to
3721 Scottsville Rd., Scottsville, NY 14546.
or fill out our Online Registration form:

Online Registration Form

Please select *
 Theater 
 Earthen Vessels 
Student's Name *

First

Last
Student's Birthday *
Address *

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Email *
Parent Home Phone Number *

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Parent Home Phone Number (secondary)

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Cell Phone Number *

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Cell Phone Number (secondary)

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Emergency Contact *

First

Last
Emergency Phone Number *

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Health Insurance Company and Number *
Known allergies and health or food restrictions or special needs *
Monday Classes
 6:80-8:00 ($25) 
June 11, 18 & 25
Tuesday Classes
 Ages 6-9; 6:00-6:45 ($20) 
 Ages 10-13; 7:00-8:00 ($25) 
June 14, 21 & 28
Honk!
 Grades 3-10 ($150) 
 Grades K-2 ($75) 
April 9th-13th; Show April 14th
Winnie The Pooh
 Grades K-6 ($100) 
July 9th-19th; Show July 21st
High School Musical
 Ages 12-18 ($175) 
July 23rd-Aug 3rd; Show Aug 4th
Community Theater
 Ages 16-Adult 
July 16th-Aug 10th
Students Dress/Shirt Size *
Students Pants Size *
Guardian Name *
Date *

MM
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DD
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By submitting this form:

I allow my child to participate in this program and hold harmless TFSD & Arts LLC. In the event of an emergency and time is a factor, I authorize the Instructors to make a decision in the best interest of my child.

Please mail payment to 3721 Scottsvile Rd., Scottsville, NY 14546

Or bring with you on first day of class.

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