2025 -26 bellAdance Customer Registration Form

Today's Date

Date

New or Returning Student/Family

Primary E-mail (Note: Email is our PRIMARY form of communication!)

Email is our #1 form of communication, please let us know if you change yours throughout the year!

Update Contact/billing information (Address/Phone No/Emergency Contacts)?

Contact and billing information:

Parent #1 Name

First NameLast Name

Parent #1 Number

Format: (000) 000-0000.

Parent #2 Name

First NameLast Name

Parent #2 Number

Format: (000) 000-0000.

Secondary E-mail

Email is our #1 form of communication, please include if you'd like a second email address to receive notices.

Address

Street Address

Street Address Line 2

CityState

Zip Code

Emergency Contact Name

First NameLast Name

Emergency Contact Phone Number

Format: (000) 000-0000.

Number of Students Registering

Students Full Name

First NameLast Name

Students' Birthday

Date

Age

Current Academic School (as of fall 2025)

Allergies or Medical Conditions we should be aware of

Years of Dance Training

Where have you trained?

How did you hear about bellA dance?

Please review the 2025-2026 Class Schedule and indicate below the class(es) you would like to register your student for. bellA dance teachers will review this form and your request and contact you regarding correct class placement prior to verifying your placement.

Additional notes/requests regarding class selection

Total hours of class per week (hours/monthly tuition) Note: This is the price for 1 dancers-there is a discount for multiple family members

Student 1 Class Selection (Please select all classes you would like to register this student for. You can select multiple classes by holding down CONTROL while clicking the class. You will specify classes for other student below)

Total hours for student #1

Additional Students Full Name

First NameLast Name

Additional Students' Birthday

Date

Age

Additional Students' Current Academic School

Allergies or Medical Conditions we should be aware of

Years of Dance Training

Where have you trained?

Additional notes regarding class selection

Student 2 Class Selection (Please select all classes you would like to register this student for. You can select multiple classes by holding down CONTROL while clicking the class)

Total Number of weekly class hours for Additional Student

Additional Students Full Name

First NameLast Name

Additional Students' Birthday

Date

Age

Additional Students' Current Academic School

Allergies or Medical Conditions we should be aware of

Years of Dance Training

Where have you trained?

Student 3 Class Selection (Please select all classes you would like to register for. You can select multiple classes by holding down CONTROL while clicking the class)

Additional notes regarding class selection

Total Number of weekly class hours for Additional Student

Total number of combined class hours for all students

Tuition Information/Policy Acknowledgement

Withdrawal Policy/Acknowledgement

Performance Agreement

Class Etiquette/Dress Code Agreement

To download a full version of the bellA dance policy agreement, click below.

Registration Fee

Single Student Registration Fee (Required)$30.00

Additional Student$20.00

Additional Student 2$20.00

Additional Student 3$20.00

Total $0.00

Credit Card

Signature

3 to 5 year old Ballet & Tap Mondays 4:30 pm - 5:30 pm
3 to 5 year old Ballet & Tap Tuesdays 4:00 pm - 5:00 pm
3 to 5 year old Ballet & Tap Fridays 4:30 pm - 5:30 pm
3 to 5 year old Ballet & Tap Saturdays 10:00 am - 11:00 am
4 to 5 year old Ballet & Tap Wednesdays 4:15 pm - 5:15 pm
4 to 6 year old Intro to Acro Wednesdays 5:15 pm-5:45 pm (30 min)
4 to 5 year old Ballet & Tap Thursdays 5:00 pm - 6:00 pm
4 to 5 year old Ballet & Tap Saturdays 11:00 am- 12:00 pm
6 to 8 year old Acro Mondays 4:15 pm - 5:00 pm (45 min)
6 to 8 year old Ballet/Tap/Jazz Mondays 5:00 pm - 6:30 pm (1.5 hr)
6 to 8 year old Ballet/Tap/Jazz Tuesday 4:30 pm - 6:00 pm (1.5 hr)
6 to 8 year old Hip Hop Wednesdays 4:15 pm - 5:15 pm (1 hr)
6 to 8 year old Ballet/Tap/Jazz Wednesdays 5:45 pm - 7:15 pm (1.5 hr)
6 to 8 year old Ballet/Tap/Jazz Thursdays 4:30 pm - 6:00 pm (1.5 hr)
6 to 8 year old Ballet/Tap/Jazz Fridays 5:30 pm - 7:30 pm (2 hr)
6 to 8 year old Acro Saturdays 9:45 am - 10:30 am (45 min)
6 to 8 year old Ballet/Tap/Jazz Saturdays 10:30 am -12:00 pm (1.5 hr)
5 to 9 year old BOYS class Tap and Hip Hop Tuesdays 5:00 pm - 6:00 pm (1 hr)
9 to 12 year old Hip Hop Wednesdays 6:45-`7:30 pm (45 min)
9 to 12 year old Jazz Wednesdays 7:30 pm - 8:15pm (45 min)
9 to 12 year old Acro Fridays 4:45 pm - 5:30 pm (45 min)
9 to 12 year old Tap Fridays 5:30 pm - 6:15 pm (45 min)
9 to 12 year old Ballet Fridays 6:15 pm - 7:00 pm (45 min)
9 to 12 year old Modern Fridays 7:00 - 7:30 (30 min)
Teen Jazz Mondays 6:30 - 7:15pm (45 min)
Teen Tap Mondays 7:15 - 8:00pm (45 min)
Teen Ballet Mondays 8:00 - 8:45pm (45 min)
Teen Hip Hop Wednesdays 7:30 pm - 8:15 pm (45 min)
Teen Modern Wednesdays 8:15 pm - 9:00 pm (45 min)
Pre-Company I
Pre- Company I + Acro
Pre-Company II
Pre Company II + Acro

3 to 5 year old Ballet & Tap Mondays 4:30 pm - 5:30 pm
3 to 5 year old Ballet & Tap Tuesdays 4:00 pm - 5:00 pm
3 to 5 year old Ballet & Tap Fridays 4:30 pm - 5:30 pm
3 to 5 year old Ballet & Tap Saturdays 10:00 am - 11:00 am
4 to 5 year old Ballet & Tap Wednesdays 4:15 pm - 5:15 pm
4 to 6 year old Intro to Acro Wednesdays 5:15 pm-5:45 pm (30 min)
4 to 5 year old Ballet & Tap Thursdays 5:00 pm - 6:00 pm
4 to 5 year old Ballet & Tap Saturdays 11:00 am- 12:00 pm
6 to 8 year old Acro Mondays 4:15 pm - 5:00 pm (45 min)
6 to 8 year old Ballet/Tap/Jazz Mondays 5:00 pm - 6:30 pm (1.5 hr)
6 to 8 year old Ballet/Tap/Jazz Tuesday 4:30 pm - 6:00 pm (1.5 hr)
6 to 8 year old Hip Hop Wednesdays 4:15 pm - 5:15 pm (1 hr)
6 to 8 year old Ballet/Tap/Jazz Wednesdays 5:45 pm - 7:15 pm (1.5 hr)
6 to 8 year old Ballet/Tap/Jazz Thursdays 4:30 pm - 6:00 pm (1.5 hr)
6 to 8 year old Ballet/Tap/Jazz Fridays 5:30 pm - 7:30 pm (2 hr)
6 to 8 year old Acro Saturdays 9:45 am - 10:30 am (45 min)
6 to 8 year old Ballet/Tap/Jazz Saturdays 10:30 am -12:00 pm (1.5 hr)
5 to 9 year old BOYS class Tap and Hip Hop Tuesdays 5:00 pm - 6:00 pm (1 hr)
9 to 12 year old Hip Hop Wednesdays 6:45-`7:30 pm (45 min)
9 to 12 year old Jazz Wednesdays 7:30 pm - 8:15pm (45 min)
9 to 12 year old Acro Fridays 4:45 pm - 5:30 pm (45 min)
9 to 12 year old Tap Fridays 5:30 pm - 6:15 pm (45 min)
9 to 12 year old Ballet Fridays 6:15 pm - 7:00 pm (45 min)
9 to 12 year old Modern Fridays 7:00 - 7:30 (30 min)
Teen Jazz Mondays 6:30 - 7:15pm (45 min)
Teen Tap Mondays 7:15 - 8:00pm (45 min)
Teen Ballet Mondays 8:00 - 8:45pm (45 min)
Teen Hip Hop Wednesdays 7:30 pm - 8:15 pm (45 min)
Teen Modern Wednesdays 8:15 pm - 9:00 pm (45 min)
Pre-Company I
Pre- Company I + Acro
Pre-Company II
Pre Company II + Acro

3 to 5 year old Ballet & Tap Mondays 4:30 pm - 5:30 pm
3 to 5 year old Ballet & Tap Tuesdays 4:00 pm - 5:00 pm
3 to 5 year old Ballet & Tap Fridays 4:30 pm - 5:30 pm
3 to 5 year old Ballet & Tap Saturdays 10:00 am - 11:00 am
4 to 5 year old Ballet & Tap Wednesdays 4:15 pm - 5:15 pm
4 to 6 year old Intro to Acro Wednesdays 5:15 pm-5:45 pm (30 min)
4 to 5 year old Ballet & Tap Thursdays 5:00 pm - 6:00 pm
4 to 5 year old Ballet & Tap Saturdays 11:00 am- 12:00 pm
6 to 8 year old Acro Mondays 4:15 pm - 5:00 pm (45 min)
6 to 8 year old Ballet/Tap/Jazz Mondays 5:00 pm - 6:30 pm (1.5 hr)
6 to 8 year old Ballet/Tap/Jazz Tuesday 4:30 pm - 6:00 pm (1.5 hr)
6 to 8 year old Hip Hop Wednesdays 4:15 pm - 5:15 pm (1 hr)
6 to 8 year old Ballet/Tap/Jazz Wednesdays 5:45 pm - 7:15 pm (1.5 hr)
6 to 8 year old Ballet/Tap/Jazz Thursdays 4:30 pm - 6:00 pm (1.5 hr)
6 to 8 year old Ballet/Tap/Jazz Fridays 5:30 pm - 7:30 pm (2 hr)
6 to 8 year old Acro Saturdays 9:45 am - 10:30 am (45 min)
6 to 8 year old Ballet/Tap/Jazz Saturdays 10:30 am -12:00 pm (1.5 hr)
5 to 9 year old BOYS class Tap and Hip Hop Tuesdays 5:00 pm - 6:00 pm (1 hr)
9 to 12 year old Hip Hop Wednesdays 6:45-`7:30 pm (45 min)
9 to 12 year old Jazz Wednesdays 7:30 pm - 8:15pm (45 min)
9 to 12 year old Acro Fridays 4:45 pm - 5:30 pm (45 min)
9 to 12 year old Tap Fridays 5:30 pm - 6:15 pm (45 min)
9 to 12 year old Ballet Fridays 6:15 pm - 7:00 pm (45 min)
9 to 12 year old Modern Fridays 7:00 - 7:30 (30 min)
Teen Jazz Mondays 6:30 - 7:15pm (45 min)
Teen Tap Mondays 7:15 - 8:00pm (45 min)
Teen Ballet Mondays 8:00 - 8:45pm (45 min)
Teen Hip Hop Wednesdays 7:30 pm - 8:15 pm (45 min)
Teen Modern Wednesdays 8:15 pm - 9:00 pm (45 min)
Pre-Company I
Pre- Company I + Acro
Pre-Company II
Pre Company II + Acro

2025-26 Dance Registration Form

Contact and billing information:

Registration Fee

Credit Card