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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 *
Parent Email *
Student Email *
Parent Home Phone Number *

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Parent Home Phone Number (secondary)

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Parent Cell Phone Number *

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Student Cell Phone Number

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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 *
Students Dress/Shirt Size *
Students Pants Size *
Date *

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By submitting this form:

I allow my child to participate in this program and hold harmless Terry Fyke's Main Street Players and their staff. 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.