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Registration Form

Please print this page for registration
**$20.00 registration fee**


For Office Use Only:
Enrollment Date: ________________________     Registration Fee Paid: _______________________


Name ____________________________________________ Date of Birth: ______________________

Address ____________________________________________________________________________

City/Zip __________________________________  Home Telephone __________________________

E-mail address________________________________________________________________________

Parent/Guardian (if under 18) __________________________________________________________

Parent(s) Work Telephone __________________________

Emergency Contact _____________________________________  Telephone ____________________

General Health _________________________________  Allergies? _____________________________

Is student on any medication? ___________________________________________________________

Class Enrollment:

Class Name ___________________________________                Tuition Fee ______________________

Day/Time _____________________________

Instructor ______________________________

Additional Classes:                         

Class Name ___________________________________                Tuition Fee ______________________     

Day/Time _____________________________

Instructor ______________________________


Class Name ___________________________________                Tuition Fee _______________________          

Day/Time _____________________________

Instructor ______________________________


Fall Class Schedule 2004-2005
General Information
Registration Form
Meet the Staff
CDT Performance Ensemble
Special Events
Photo Album
Activity Page
Paper Dolls
Contact CDT