Student's Name: Date of Birth: No Are there any other family members registering?     Yes Parent's Names: Street Address: City: State: Zip Code: Home Phone: Work/Cell Phone: Student E-Mail Address: Parent E-Mail Address: Emergency Contact: Emergency Phone: JFK Student School Yellow Pages/Yellow Book Newspaper Ad Attended Performance Other How did you hear about us? Describe your previous dance experience: Hold "Ctrl" and click to make multiple selections Tuition $99 per child Teddy Bear I Teddy Bear II Hawaiian Beach Party I Hawaiian Beach Party II Fairy Garden Fantasy I Fairy Garden Fantasy II Fairy Garden Fantasy III Tuition is non-refundable Pay by Check Submit registration online then Drop off or Mail check to: Just For Kicks 404 Second Avenue Mason, OH 45040 Registration will be held for one week until we receive your check.  Thanks. Pay by Credit Card Name on Card Master Card Visa Card Number Exp. Date Security Code Amount Is billing address same as above? Y N If no, please provide billing address.