Come Dance With Your Baby

Registration Form

Please fill out the registration form below. If you sign up online you will need to sign a waiver form at your first class. You can alternatively click here to download the registration form which is to be completed and mailed in.

Details
*Full Name:  
*Baby's Name:  
*Baby's Age:  
*Phone Number:  
*Email:  
Street Address:  
City:  
Postal Code:  

Class Information
Class Date:  
Class Time:  
Location:  

Emergency Contact
Full Name:  
Relationship:  
Phone Number:  
Cell / Pager:  

Medical Information
Doctor's Name:  
Doctor's Phone:  
Health / Allergies:  

How did you hear about Baby Steps Dance?

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