Parent/Guardian Name
*
First Name
Last Name
Phone Number
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Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Dancer Name
*
First Name
Last Name
What Age/Grade Category Does Your Dancer Fall Into?
*
Please Select
Younger than 2
Age 2 By Oct 1
Age 3 By Oct 1
Age 4 By Oct 1
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Dancer's Birthdate
*
-
Month
-
Day
Year
Date
Age 2 By Oct 1
Please Select
Little Explorers Monday 5:30pm (Week 1)
Little Explorers Saturday 9:00am(Week 1)
Little Explorers Monday 5:30pm (Week 2)
Little Explorers Saturday 9:00am(Week 2)
Little Explorers Monday 5:30pm (Week 3)
Little Explorers Saturday 9:00am(Week 3)
Little Explorers Monday 5:30pm (Week 4)
Little Explorers Saturday 9:00am(Week 4)
Age 3 By Oct 1
Please Select
Debut Darlings Saturday 9:45am(Week 1)
Debut Darlings Saturday 9:45am(Week 2)
Debut Darlings Saturday 9:45am(Week 3)
Debut Darlings Saturday 9:45am(Week 4)
Age 4 By Oct 1
Please Select
Dancin Cuties Monday 7pm (Week 1)
Dancin Cuties Tuesday 5:30pm (Week 1)
Dancin Cuties Saturday 10:15am (Week 1)
Dancin Cuties Monday 7pm (Week 2)
Dancin Cuties Tuesday 5:30pm (Week 2)
Dancin Cuties Saturday 10:15am (Week 2)
Dancin Cuties Monday 7pm (Week 3)
Dancin Cuties Tuesday 5:30pm (Week 3)
Dancin Cuties Saturday 10:15am (Week 3)
Dancin Cuties Monday 7pm (Week 4)
Dancin Cuties Tuesday 5:30pm (Week 4)
Dancin Cuties Saturday 10:15am (Week 4)
Mini Program (Kindergarten & 1st Grade)
Please Select
Ballet Tuesday 6:00pm (Week 1)
Tap Tuesday 6:30pm (Week 1)
Hip Hop Tuesday 7:00pm (Week 1)
Ballet Wednesday 5:30pm (Week 1)
Tap Wednesday 6:00pm (Week 1)
Hip Hop Wednesday 6:30pm (Week 1)
Jazz Wednesday 7:00pm (Week 1)
Hip Hop Saturday 9:30am (Week 1)
Tap Saturday 10:00am (Week 1)
Ballet Saturday 10:30am (Week 1)
Jazz Saturday 11:00am (Week 1)
Ballet Tuesday 6:00pm (Week 2)
Tap Tuesday 6:30pm (Week 2)
Hip Hop Tuesday 7:00pm (Week 2)
Ballet Wednesday 5:30pm (Week 2)
Tap Wednesday 6:00pm (Week 2)
Hip Hop Wednesday 6:30pm (Week 2)
Jazz Wednesday 7:00pm (Week 2)
Hip Hop Saturday 9:30am (Week 2)
Tap Saturday 10:00am (Week 2)
Ballet Saturday 10:30am (Week 2)
Jazz Saturday 11:00am (Week 2)
Ballet Tuesday 6:00pm (Week 3)
Tap Tuesday 6:30pm (Week 3)
Hip Hop Tuesday 7:00pm (Week 3)
Ballet Wednesday 5:30pm (Week 3)
Tap Wednesday 6:00pm (Week 3)
Hip Hop Wednesday 6:30pm (Week 3)
Jazz Wednesday 7:00pm (Week 3)
Hip Hop Saturday 9:30am (Week 3)
Tap Saturday 10:00am (Week 3)
Ballet Saturday 10:30am (Week 3)
Jazz Saturday 11:00am (Week 3)
Ballet Tuesday 6:00pm (Week 4)
Tap Tuesday 6:30pm (Week 4)
Hip Hop Tuesday 7:00pm (Week 4)
Ballet Wednesday 5:30pm (Week 4)
Tap Wednesday 6:00pm (Week 4)
Hip Hop Wednesday 6:30pm (Week 4)
Jazz Wednesday 7:00pm (Week 4)
Hip Hop Saturday 9:30am (Week 4)
Tap Saturday 10:00am (Week 4)
Ballet Saturday 10:30am (Week 4)
Jazz Saturday 11:00am (Week 4)
Petite Program (2nd & 3rd Grade)
Please Select
Jazz Monday 5:15pm (Week 1)
Tap Monday 6:45pm (Week 1)
Tap Tuesday 6:45pm(Week 1)
Jazz Thursday 6:00pm (Week 1)
Jazz Monday 5:15pm (Week 2)
Tap Monday 6:45pm (Week 2)
Tap Tuesday 6:45pm(Week 2)
Jazz Thursday 6:00pm (Week 2)
Jazz Monday 5:15pm (Week 3)
Tap Monday 6:45pm (Week 3)
Tap Tuesday 6:45pm(Week 3)
Jazz Thursday 6:00pm (Week 3)
Jazz Monday 5:15pm (Week 4)
Tap Monday 6:45pm (Week 4)
Tap Tuesday 6:45pm(Week 4)
Jazz Thursday 6:00pm (Week 4)
Tween Program (4th & 5th Grade)
Please Select
Ballet Monday 5:15pm (Week 1)
Tap Monday 6:00pm (Week 1)
Boyz HH 6:15pm (Week 1)
Jazz Monday 6:45pm (Week 1)
Tap Tuesday 6:45pm (Week 1)
Lyrical Tuesday 6:45pm (Week 1)
Jazz Thursday 5:15pm (Week 1)
Acro Thursday 6:00pm (Week 1)
Hip Hop Thursday 6:45pm (Week 1)
Lyrical Thursday 6:45pm (Week 1)
Ballet Monday 5:15pm (Week 2)
Tap Monday 6:00pm (Week 2)
Boyz HH 6:15pm (Week 2)
Jazz Monday 6:45pm (Week 2)
Tap Tuesday 6:45pm (Week 2)
Lyrical Tuesday 6:45pm (Week 2)
Jazz Thursday 5:15pm (Week 2)
Acro Thursday 6:00pm (Week 2)
Hip Hop Thursday 6:45pm (Week 2)
Lyrical Thursday 6:45pm (Week 2)
Ballet Monday 5:15pm (Week 3)
Tap Monday 6:00pm (Week 3)
Boyz HH 6:15pm (Week 3)
Jazz Monday 6:45pm (Week 3)
Tap Tuesday 6:45pm (Week 3)
Lyrical Tuesday 6:45pm (Week 3)
Jazz Thursday 5:15pm (Week 3)
Acro Thursday 6:00pm (Week 3)
Hip Hop Thursday 6:45pm (Week 3)
Lyrical Thursday 6:45pm (Week 3)
Ballet Monday 5:15pm (Week 4)
Tap Monday 6:00pm (Week 4)
Boyz HH 6:15pm (Week 4)
Jazz Monday 6:45pm (Week 4)
Tap Tuesday 6:45pm (Week 4)
Lyrical Tuesday 6:45pm (Week 4)
Jazz Thursday 5:15pm (Week 4)
Acro Thursday 6:00pm (Week 4)
Hip Hop Thursday 6:45pm (Week 4)
Lyrical Thursday 6:45pm (Week 4)
What Age/Grade Category Does Your Dancer Fall Into?
Please Select
Younger than 2
Age 2 By Oct 1
Age 3 By Oct 1
Age 4 By Oct 1
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Parents, legal guardians of minors and adults waive the right to any legal action for any injury sustained on Dance It Up with Music Property or event resulting from normal class/physical activity or any other activity conducted by the participant before, during or after class time. I have my own medical insurance to cover any and all medical bills or related bills that may arise from the nature of the activity. I release Dance It Up with Music from all financial responsibility from any expense that is incurred for any unfortunate situation that may occur. I also consent to my child's photo being used in any images or marketing by Dance It Up with Music.
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