XDC Enrollment Form

CLICK HERE FOR CLASS DESCRIPTION AND SCHEDULE

For more information log onto www.thexperiencedc.com
This form is for class and performance- related payments only! To purchase merch or required dance attire, please click HERE
Parent's Name*
Type N/A if older than 18
Email Address*
Address (City, State and Zip)*
Phone Number*
Cell Phone
Are you enrolling, paying for Master Classes or paying performance related fees?*

EnrollingPayment-related feesPaying for Master Classes
How did you find out about our program?*

InstagramFacebookSearch EngineStudent/ Parent Referral
If you answered Student/ Parent Referral, please enter the individual's name here*
TYPE N/A IF NO ONE REFERRED YOU
Is your child a student at Universal Creighton Charter School? (IF YES ENTER CODE: UCCS AT CHECKOUT)

YesNo
if a Creighton Scholar, please enter your child’s most recent report card as proof of enrollment

Cancelof

Dancer's Name
Dancer's Name*
Dancer's Email*
example@example.com
Age*
DOB*

MonthDayYear
Date
Please list any previous dance experience your child may have*
Is this dancer a sibling?*

YesNo

Sibling 1
Dancer's Name
If dancer is a sibling, please list the oldest sibling first
Dancer's Email
example@example.com
Age
DOB

MonthDayYear
Please list any previous dance experience your child may have
Sibling 2
Dancer's Name
If dancer is a sibling, please list the oldest sibling first
Dancer's Email
example@example.com
Age
DOB

MonthDayYear
Date
Please list any previous dance experience your child may have
Sibling 3
Dancer's Name
If dancer is a sibling, please list the oldest sibling first
Dancer's Email
example@example.com
Age
DOB

MonthDayYear
Date
Please list any previous dance experience your child may have

NEW RATES

Effective July 1, 2025

CLASS SELECTION
PLEASE SUBMIT YOUR ONE-TIME (NON-REFUNDABLE) REGISTRATION FEE PER CHILD. YOU WILL THEN RECEIVE A FOLLOW-UP FORM TO CONFIRM YOUR CLASSES. ONCE CONFIRMED, YOU WILL THEN RECEIVE YOUR FIRST INVOICE.

New Enrollment Registration Fee (NON-REFUNDABLE)- REQUIRED FOR FALL CLASSES ONLYDUE AT THE TIME OF ENROLLMENT (one time fee per dancer to cover miscellaneous unforeseen costuming, operational and performance expenses)- This is not required for the $5 trial or summer classes

$85.00 Quantity

Returning Enrollment Registration Fee (NON-REFUNDABLE)- REQUIRED FOR FALL CLASSES ONLYDUE AT THE TIME OF ENROLLMENT (one time fee per dancer to cover miscellaneous unforeseen costuming, operational and performance expenses)- This is not required for the $5 trial or summer classes

$70.00 Quantity

Enter coupon

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Would you like your future monthly payments broken into 2 installments for an additional 7% installment fee?

YesNo
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that the activities held at The X-Perience Dance Company are physical in conduct and could potentially result injury. I am aware of the potential risk associated with dance. However, XDC will not be held accountable in the event of a dance/ acrobatic or any physical activity related injury. Upon enrollment, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.
Signature*

Clear
Date

MonthDayYear
Date

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

Dancer's Name

Sibling 1

Sibling 2

Sibling 3

NEW RATES

CLASS SELECTION