Sampada's Dance Studio
Sampada's Dance Studio
Registration Form


  • This form need to be filled only  by those who join our class. For all general inquiries, please contact at
  • Once this form is filled, you would receive an email containing the registration details. Please print the copy of this email, sign it and submit it along with registration charges in your first class.
How did you hear about us? *  
Studio Location  

Particular of Students

Name *  
Gender *  
Male Female
Date of Birth *  
Address *  
Email *  
Phone *  
Name of School and Class  

Particular of Parents (To be filled for children's class)

Parent's Name  
Phone (Home)  
Phone (Mobile)  
I have read and
agree with the
Registration and
Course Fee Policy *

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