Register for First Steps Register Now for First Steps Please complete the form below. When you submit, you will pay with a credit card via PayPal. We will contact you shortly to confirm your registration. Thank you! Parent’s or Guardian’s Name* Phone*Email* Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Any Other Emergency Contact Info. (if desired) Consent*I am aware of the nature of the programs offered by Howell Academy of Dance. I do waive, release, absolve, indemnify and agree to hold harmless the organizers, sponsors, participants and any persons involved in the operation of Howell Academy of Dance programs for any claims arising out of injury or other loss to named applicant or any member of his/her family whether as a participant in activities or as a spectator. This includes participation on any properties where students are performing. I agree to the above policy.Parent’s or Guardian’s Digital Signature:* Student InformationStudent’s Name Prefers to be called Student's Age Date of Birth School Attending Medical Concerns (if any)Select ClassesPlease put a 1 in the quantity of the class you would like to register this student for. After you submit the form, you will pay via paypal with a credit card.First Steps... 5 weeks Jan/FebWednesdays - 10:30am to 11am. January 5, 12, 19, 26 & Feb 2 Price: $60.00 Quantity: Total $0.00 CAPTCHANameThis field is for validation purposes and should be left unchanged.