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Sampada's Dance Studio
Choreographer Sampada
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Registration
Form
Guidelines:
This form need to be filled only by those who join our class. For all general inquiries, please contact at
info@sampadadance.com.sg
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?
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Email
Flyer
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Trial Class
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If other, mention here:
Studio Location
Particular of Students
Name
*
Gender
*
Male
Female
Date of Birth
*
Address
*
Email
*
Phone
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Name of School and Class
Particular of Parents (To be filled for children's class)
Parent's Name
Phone (Home)
Phone (Mobile)
Email
I have read and
agree with the
Registration
and
Course Fee Policy
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