Fort Dodge, Iowa Dance & Gymnastics

Summer Enrollment

Name:______________________________ Age:______________

Parent’s Name:_______________________ Birthday:______­­­­­______

Address:____________________________ Phone:_____________

Cell Phone:_________________________ Enrollment Fee 15.00____

Parent’s Signature:_____________________

Class Times:__________________________ Amount Paid:_______

Email Address:__________________________

SOLO / DUET SIGN UP

(List choices as 1st, 2nd, and 3rd, you will be notified as to your time)

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721 South 25th Street
Fort Dodge, Iowa 50501

Phone: 515-576-3279
Fax: 515-576-0348
Email: dancer01@frontiernet.net

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