Register for Dance & Fitness Classes

Personal Information

Participant 1 Name

Participant 2 Name

Participant 3 Name

 

Parent or Guardian's Name

Address City Zip

Home Phone (please include area code): ( )   

Cell Phone (please include area code): ( )   

Email Address

 

Participant 1 Age: Birthdate (ex: 6/15/97) Grade in School

Participant 2 Age: Birthdate (ex: 6/15/97) Grade in School

Participant 3 Age: Birthdate (ex: 6/15/97) Grade in School

 

Please indicate the type of class or classes you are interested in below:

Class: Day: Time:

Class: Day: Time:

Class: Day: Time:

 

 

 

 

 

Kick It Up Dance & Fitness Studio            8125 & 8129 E. Wardlow Rd.            Long Beach, CA 90808            562-430-1812            info@kickitup.com
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