Day
Time
3 Year Old Classes
Class Type
Monday
4:45-5:30
Princess Ballet/Tiny Tap
Combo
Wednesday
5:30-6:00
Princess Ballet
Day
Time
Shoes
Teacher
Pink Leather/White Tap
Ms. Carrie
Pink Leather
Ms. Roxana
Shoes
Teacher
Pink Leather/White Tap
Ms. Carrie
Ms. Sue
Ms. Sue
Ms. Sue
Ms. Roxana
4 Year Old Classes
Class Type
Monday
4:45-5:30
Princess Ballet/Tiny Tap
Combo
Tuesday
Tuesday
Tuesday
Wednesday
5:00-5:30
5:30-6:00
6:00-6:30
5:30-6:00
Princess Ballet
Pink Leather
Tap
Mary Jane Buckle Tan Bloch
Jazzy Hip-Hop
Carmel Super Jazz S0401
Princess Ballet
Pink Leather
Day
Time
Young 5’s / Kindergarten
Class Type
Shoes
Monday
4:45-5:30
Princess Ballet/Tiny Tap
Combo
Monday
Monday
Monday
Tuesday
Tuesday
5:30-6:15
6:15-6:45
6:45-7:15
5:00-5:30
5:30-6:00
Ballet
Tap
Jazzy Hip-Hop
Mary Jane Buckle Tan Bloch
Princess Ballet
Pink Leather
Tap
Mary Jane Buckle Tan
Bloch
Tuesday
6:00-6:30
Jazzy Hip-Hop
Carmel Super Jazz S0401
Day
Time
Monday
Monday
Monday
Tuesday
Tuesday
Tuesday
5:30-6:15
6:15-6:45
6:45-7:15
5:00-5:30
5:30-6:00
6:00-6:30
1st Grade
Class Type
Teacher
Pink Leather/White Tap
Ms. Carrie
Pink Leather
Ms. Carrie
Ms. Carrie
Ms. Carrie
Ms. Sue
Ms. Sue
Carmel Super Jazz SO401
Ms. Sue
Shoes
Teacher
Pink Leather
Ms. Carrie
Ms. Carrie
Ms. Carrie
Ms. Sue
Ms. Sue
Ms. Sue
Ballet
Tap
Jazzy Hip-Hop
Mary Jane Buckle Tan Bloch
Princess Ballet
Pink Leather
Tap
Mary Jane Buckle Tan Bloch
Jazzy Hip-Hop
Carmel Super Jazz S0401
Carmel Super Jazz SO401
**=Pre-approval needed please call office
Day
Time
Monday
Monday
Monday
Thursday
Thursday
Thursday
Thursday
Thursday
5:30-6:15
6:15-6:45
6:45-7:15
5:00-5:45
5:00-5:45
5:45-6:15
6:15-6:45
7:15-8:00
Day
Time
Tuesday
Tuesday
Tuesday
Thursday
Thursday
Thursday
Thursday
Thursday
5:00-5:30
5:30-6:15
6:15-7:00
5:00-5:45
5:00-5:45
5:45-6:15
6:15-6:45
7:15-8:00
Day
Time
Tuesday
Tuesday
Tuesday
Wednesday
Thursday
Thursday
Thursday
Thursday
5:00-5:30
5:30-6:15
6:15-7:00
6:30-7:15
5:00-5:45
5:00-5:45
5:45-6:15
6:15-6:45
2nd Grade
Class Type
Ballet
Tap
Jazzy Hip-Hop
Ballet
Shoes
Teacher
Pink Leather
Ms. Carrie
Ms. Carrie
Ms. Carrie
Ms. Roxana
Ms. Susan
Ms. Roxana
Ms. Roxana
Ms. Sue
Mary Jane Buckle Tan Bloch
Carmel Super Jazz SO401
Pink Leather
Modern
Tap
Jazz
Poms/Hip-Hop
3rd Grade
Class Type
Mary Jane Buckle Tan Bloch
Carmel super jazz
Black dance sneaker/Carmel
super jazz
Shoes
Teacher
Tap
Ballet
Black slip on Bloch
Jazz
Carmel super Jazz
Ballet
Pink Leather
Ms. Roxana
Ms. Roxana
Ms. Roxana
Ms. Roxana
Ms. Susan
Ms. Roxana
Ms. Roxana
Ms. Sue
Pink Leather
Modern
Tap
Jazz
Poms/Hip-Hop
4th Grade
Class Type
Mary Jane Buckle Tan Bloch
Carmel Super Jazz
Black Dance Sneaker/Carmel
super Jazz
Shoes
Teacher
Tap
Ballet
Black Slip on Bloch
Jazz
Carmel Super Jazz
Ms. Roxana
Ms. Roxana
Ms. Roxana
Ms. Roxana
Ms. Roxana
Ms. Susan
Ms. Roxana
Ms. Roxana
Pink Leather
Contemporary/Lyrical
Ballet
Pink Leather
Modern
Tap
Jazz
Mary Jane Buckle Tan Bloch
Carmel super Jazz
Thursday
7:15-8:00
Poms/Hip-Hop
Black Dance Sneaker/Carmel
super Jazz
Ms. Sue
**=Pre-approval needed please call office
Day
Tuesday
Tuesday
Tuesday
Wednesday
Thursday
Thursday
Thursday
Thursday
Thursday
Time
5:00-5:30
5:30-6:15
6:15-7:00
6:30-7:15
5:00-5:45
5:00-5:45
5:45-6:15
6:15-6:45
7:15-8:00
Day
Time
Monday
Monday
Monday
Wednesday
Wednesday
Wednesday
Thursday
4:45-5:15
5:15-6:00
6:00-6:45
5:30-6:00
6:00-6:30
6:30-7:15
5:45-6:30
Day
Time
Tuesday
Tuesday
Tuesday
Tuesday
Wednesday
Wednesday
Wednesday
Wednesday
Wednesday
Thurday
Thursday
6:30-7:00
7:00-7:45
7:45-8:30
8:30-9:00
5:30-6:00
5:45-6:15
6:00-6:45
7:15-7:45
6:45-7:30
6:30-7:15
7:15-8:15
5th Grade
Class Type
Shoes
Teacher
Tap
Ballet
Black slip on Bloch
Jazz
Carmel super Jazz
Contemporary/Lyrical
Adage turner
Modern
No shoe
Ballet
Tap
Jazz
Poms/Hip-Hop
Pink Leather
Ms. Roxana
Ms. Roxana
Ms. Roxana
Ms. Roxana
Ms. Susan
Ms. Roxana
Ms. Roxana
Ms. Roxana
Ms. Sue
Pink Leather
Mary Jane Buckle Tan Bloch
Carmel super jazz
Black Dance Sneaker/Carmel
super Jazz
Middle School/Teens
Class Type
Shoes
**Tap**
**Ballet**
**Jazz**
Hip-Hop
Poms
Black Slip on Bloch
Pink Leather split sole
Carmel super Jazz
Contemporary/Lyrical
Adage turner
Modern
No shoe
Carmel super Jazz
Black Dance Sneaker
Middle School/Teens
Class Type
Hip-Hop
Teacher
Ms. Roxana
Ms. Roxana
Ms. Roxana
Ms. Sue
Ms. Sue
Ms. Roxana
Ms. Susan
Shoes
Teacher
Carmel Super Jazz
Carmel Super Jazz
Pink Leather
Ms. Sue
Ms. Sue
Ms. Roxana
Ms. Roxana
Ms. Sue
Ms. Roxana
Ms. Sue
Ms. Roxana
Ms. Sue
Ms. Susan
Ms. Susan
Jazz
Ballet/Lyrical/Turns
Tap
Hip-Hop
**Tap**
Poms
**Lyrical**
Black slip on Bloch
Black Dance Sneaker
Adage turner
**Hip-Hop**
Carmel Super Jazz
**Modern**
No shoe
**Ballet**
Pink Leather
Black slip on Bloch
Black Dance Sneaker
Thursday
8:15-9:00
**Jazz**
Carmel Super Jazz
Ms. Susan
**=Pre-approval needed please call office
Day
Time
Monday
Wednesday
Tuesday
Wednesday
Wednesday
6:45-7:30
7:15-7:45
7:00-7:45
4:30-5:30
4:45-5:30
Multiage Classes
Class Type
**Cecchetti Grade 2**
**Pointe**
Cecchetti Grade 1
**Cecchetti Grade 5**
Boys Hip-Hop
Shoes
Teacher
Pink Leather
Ms. Roxana
Ms. Roxana
Ms. Roxana
Ms. Roxana
Ms. Sue
Pink Leather
Pink Leather
**=Pre-approval needed please call office
Roxana’s Dance Expressions of Clarkston
5807 M-15 · Clarkston, MI 48346 · Phone (248) 625-1930 ·
P.O Box 744 Clarkton 48347
Registration/Consent Form
Please use ONE registration form per child.
otherwise requested.
Accounts are listed under the mother’s name unless
Mother’s Name: First _________________________ Last ____________________
Address: _____________________________________________________________
City: ________________ Zip Code: _____________ Home Phone: (_____) _________
E-Mail Address: _______________________________________________________
Mother’s Cell Phone Number: ____________________
Mother’s Workplace Name: _________________________ Phone: (_____) ________
Father’s Name: First ______________________ Last _________________________
Father’s Cell Phone Number: _____________________
Father’s Workplace Name: __________________________ Phone: (_____) _________
Dancer’s Name: _____________________________________________
Recreational Dancer: Yes No
Competition Dancer: Yes No
Dancer’s E-Mail Address: ________________________________________________
Dancer’s School: __________________________________ City: ________________
Dancer’s Current Grade at School: _________ Birth Date: ____________________
Special Medical Attention (Describe): _______________________________________
_____________________________________________________________________
How did you hear about us? ______________________________________________
I agree that I will not hold the facility, or any faculty member or employee liable for injuries sustained or
illnesses contracted by my daughter/son while a student of Roxana’s Dance Expressions. I/We give our
child permission to attend dance classes at Roxana’s Dance Expressions. I/We have read and
understand all the information provided at the time of registration.


I give my permission to have my child’s photo appear on Roxana’s Dance Expressions web site.
I DO NOT want my child’s photo to appear on Roxana’s Dance Expressions web site.
Parent/Guardian Signature:
____________________________________________________________
The first and last month’s tuition fee, plus a one-time non refundable registration fee $15.00 per
dancer or $35.00 for family of 3 is due at the time of registration.
Please make checks payable to Dance Expressions.
Tuition payments are due on the first of the month. Late fees will be assessed on the 10th.
Registration Fee Paid: Yes / No
Check Number: __________________ Date ____/____/____ Amount: $____________________
Please use the back of this form to list the classes you wish to enroll your dancer in.
If ever having financial difficulties please call & talk to Roxana, we can always work something out.
Student Enrollment Section
Please fill in your first choice for classes. If we need to put your child into an alternative class, we will
contact you by phone.
Date of Registration ________/________/________ Returning Student _______ or New Student ______
Class
Day
Time
End
Time
Tuition
Amount
Teacher
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Total Monthly
Tuition Amount
$
FEE SCHEDULE PER DANCER
# of classes
One Class
Two Classes
Three Classes
Four Classes
Five Classes
Each Additional Class
1st Dancer
$41
$75
$105
$131
$153
$10 per class
Each Additional Dancer
$38
$68
$95
$119
$139
$10 per class
Combo Class…………..10 payments of $60
Tuition for the competition Team classes & Solo Duet/Trio are in the hand Book.
Office
Use