Dancer Registration: December January Session

Studio Address:
435 N. 10th Street in Lewisburg

December January Session
Dancer Registration Form

You will need a printer to complete registration.

Today's Date *

Month Day Year

Child 1's Name *

First Name Last Name

Child 2's Name

First Name Last Name

Child 3's Name

First Name Last Name

Parent's Name *

First Name Last Name

Parent's Primary Email *

example@example.com

Secondary Email *

example@example.com

Would you like us to email both addresses? *

Yes, both Primary only

Mom's Cell Number *

Area Code Phone Number

Dad's Cell Number *

Area Code Phone Number

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Emergency Contact, Relation, & Cell # *

How did you hear about us? *

Current/Past Student From a Friend Facebook Instagram Google Search Local Performance

Child 1's Birthday *

Date

Child 2's Birthday

Date

Child 3's Birthday

Date

Child 1, 2, 3 Age(s) on Aug. 24, 2020 *

School

Does the dancer have any medical problems that we should be aware of? If yes, please explain. *

December Class Selections:

Zoom: "ELF the Musical" Musical Theater Dance, Beginner, Ages 8-12, 4:30-5:30, Dates: Th Dec 3, Th Dec 10, Th Dec 17 & Fri Dec18 *4 Classes with Miss Jillian* Zoom: "ELF the Musical" Musical Theater Dance, Intermediate, Ages 10-13, 5:45-6:45, Dates: Th Dec 3, Th Dec 10, Th Dec 17 & Fri Dec18 *4 Classes with Miss Jillian* Zoom: Sugarplum Fairy (Nutcracker) Ballet, Beginner Ages 7-9, 5:15-6:15, M-Thu- Mon Dec 14, 15, 16, & Thu Dec 17, *4 Classes with Miss Jenna*

January Class Selctions:

In-Person: Hip Hop Jazz Fusion Ages 5-7, Mondays 5:45-6:45pm, Dates: Jan 4, 11, 18, 21 *4 Classes with Miss Amanda* Snow Date: Tues Jan 22, same time In-Person: Hip Hop Jazz Fusion, Experienced Ages 8-12, Mondays 7-8pm, Dates: Jan 4, 11, 18, 21 *4 Classes with Miss Amanda* Snow Date: Tues Jan 22, same time. Zoom: Hip Hop Jazz Fusion, Beginner, 4:30-5:30, Ages 7-9, Dates: Tuesdays Jan.5, 12, 19, 26 *4 Classes with Miss Lauren* Zoom: Intermediate Jazz, 5:45-6:45, Ages 10-13, Tuesdays Jan.5, 12, 19, 26 *4 Classes with Miss Lauren*

If registering for siblings, please specify which child is taking which class

Age Recommendations:

Have a dancer who's older or younger than the class' recommended age? Email Miss Christine at downtowndancepa@gmail.com to see if you can join anyway.

Teens & Preschoolers: We don't have any classes slated just for your age group, but if we hear there's interest, we will add one! Complete our Class Request Form.

In-Person Class, Covid Safety Measures:

Masks Required
Temperature & Screening Questions at the Door
Hand Sanitizing Upon Entry & Exit
Dancing in Socially Distanced, 6 x 6 Boxes
Disinfecting Between Classes & Air Purifiers On
Class Size Reduced to 10 Dancer Max.

PRINT, SIGN, UPLOAD: 2 Waivers

Upload signed Waivers *

Browse Files

For Zoom classes-

We'll send you the Zoom link & passwords one week prior to classes starting. If you do not receive it by then, email us.

For In-Person classes-

Dress
Wear your mask. Hair must be pulled back. Dress is active wear and sneakers. Please bring your sneakers in a dance bag so we keep the studio dry, safe & clean. Keep water, an extra mask, extra hair tie, etc. in/with your bag.

Screening Questions
We will ask you for Covid related symptoms, if you have traveled recently & if you've been in contact with someone confirmed positive for Covid.

If you have a symptom that could be Covid, please do not come to class for 2 weeks. Contact us & we'll arrange a make-up. If you have traveled to a state that's on the quarantine list, same thing. Thanks for your cooperation on this!

Payment *

1 Class (4-Class Session) $ 60.00

2nd Class + $ 60.00

3rd Class+ $ 60.00

Total $ 0.00