(803) 432-7477
ari@thedanceplacesc.com
2639AB N. Broad St. Camden, SC

South Carolina Center for Cecchetti USA

Student's Name
Mailing Address
City State Zip
Phone Number Birth Date // Age
Email
School Grade
Mother's Name Daytime Phone
Father's Name Daytime Phone
Dance Experience Studio
Food Allergies
Additional information you would like the teacher to be aware of:
Additional people who are allowed to pick up your child:
Name Relationship to Child
Name Relationship to Child
Name Relationship to Child
Name Relationship to Child
Pay $10 Deposit By: Credit/Debit Bringing In Person Mailing a Check

For technical support, contact us at (803) 432-7477 or katherine@thedanceplacesc.com.

Photography Credits: Jimmy Wood and Anthony Hawkesworth | Website by Katherine Dickinson