Broadway Bound Theatrical and Dance Center, Lyndhurst, NJ

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Broadway Bound Summer Registration Form

To sign up please complete the following form and press the ""Printable Registraion Form" button at the bottom of the page. The printable registration form has further instructions for mailing in the form and registration fee(s).

Student's First Name:	Last Name:		Birth Date (mm/dd/yyyy):

Parent's First Name:	Last Name:

Address (Line 1):

Address (Line 2):

City:	State:	Zip Code:

Home Phone Number:	Work Phone Number:

E-mail:

Are you new to Broadway Bound?
Yes, I am a new student at Broadway Bound.
No, I have been a student at Broadway Bound since .
Please give a brief description of any past experience or training below.

How did you find out about Broadway Bound?
Friend TV Commercial Newspaper Article Newspaper Ad Yellow Pages Registration Notice Money Mailer Coupon Internet Other
Please select the classes, along with the days and times, that you are interested in: Please note that classes and class schedules are determined by enrollment. Broadway Bound will contact you before classes begin with a final schedule.

Tuesday
	Class	Time	Duration	Price Per Class
	Ballet Level I (7-10yr.old)	5pm	1 hr.	$12.00
	Tap Level I (7-10 yr. old)	6pm	1 hr.	$12.00
	Ballet Level II (11--15 yr. old)	6pm	1 hr.	$12.00
	Tap Level II (11-15 yr. old)	7pm	1 hr.	$12.00
	Jazz Level I (7-10 yr. old )	7pm	1 hr.	$12.00
	Jazz Level II ( 11- yr. old)	8pm	1 hr.	$12.00

Wednesday
	Class	Time	Duration	Price Per Class
	Leap, Stretch & Turn Class( 7/13-8/17)	6:30PM	1 hr.30 min.	$17.00
	Voice (Group) * may add extra day	4:00PM	1 hr.	$15.00
	Voice (Private) * may add extra day	4:00PM	30 min.	$30.00
	Piano (private)	4:00PM.	30 min.	$25.00

Thursday
	Class	Time	Duration	Price Per Class
	Ballet Level I (7-10yr.old)	5pm	1 hr.	$12.00
	Tap Level I (7-10 yr. old)	6pm	1 hr.	$12.00
	Ballet Level II (11--15 yr. old)	6pm	1 hr.	$12.00
	Tap Level II (11-15 yr. old)	7pm	1 hr.	$12.00
	Jazz Level I (7-10 yr. old )	7pm	1 hr.	$12.00
	Jazz Level II ( 11- yr. old)	8pm	1 hr.	$12.00

For a printable registraion form you can mail in today please click
"Printable Registraion Form."

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