2010 Registration Form Hockessin Dance Center, Inc. Please complete one for each child. Student's Full Name:  * required Age: (as of Sept 2010)  * required Birthday:  * required School and Grade:  * required Does the student have any allergies or medical conditions we should know? Yes No (List if any) New/Returning Student New Student Returning Student How did you hear about HDC? Email Address:  * required Student's Email Address: Parent/Guardian's Name:  * required Relationship to Student: Mother Father Self Other Full Address (including street, city, state and zip) Home Phone:  * required Cell:  * required Additional Phone #: Emergency Contact (other than parent/guardian)  * required Relationship to Student: Mother Father Grandparent Aunt/Uncle Neighbor Family Friend Other Phone #:  * required       2010-2011 Schedule Mini (ages 2/3) Sat 9:15am PK-K (ages 3-5) Sat 10am PK/JK(ages 3/4) Mon 4:30pm JK/K (ages 4/5) Tue 4:45pm Combo: Ballet/Jazz (ages 6-9) Sat 11am Combo: Ballet/Jazz (ages 6-9) Mon 6:15pm Adv Combo: Ballet/Jazz (10-12) Sat 12:15pm Ballet (09 Mon 5:30) Thu 5:30pm Int Ballet & Pointe (09 Thu 5:45) Thu 6:30pm Adv Ballet & Pointe (09 Mon 6:30) Thu 7:45pm Jazz/Lyr (Fame) Sat 1:45pm Int Jazz: (Sweat) Wed 6:30pm Adv Jazz: (B&G) Tue 7:30pm Int/Adv Lyrical: Tue 6:30pm Tap: (ages 6-9) Mon 5:30pm Tap: (ages 10-12) Tue 5:45pm Beg Teen Tap: Fri 4:15pm Int Tap: (Sharks) Wed 7:45pm Adv Tap: (Jets) Wed 5:45pm Hip Hop (ages 6-9) Fri 6pm Hip Hop (ages 10-13) Fri 7pm Hip Hop (ages 14+) Fri 5pm Performance Team (ages 6-9) Sat 5-6pm Performance Team (ages 10-13) Sat 3-4pm Performance Team (ages 14+) Sat 4-5pm Young Adult Special Needs Dance: Wed 5pm Monday Workshops & Other... Zumba ~ Sept 11- Oct 18th Latin Club Dance ~ Oct 25th & Nov 1st Basic Acting for Dancers ~ Nov 8-29th Adult Beg Ballet ~ Dec 6, 13, 20 & Jan 3 Street Hip Hop ~ Jan 10-31st Private Wedding Lessons Pageant/Audition Dance Package Private Lessons Birthday Parties Gift Certificate Comments: