Registration Form

Registration Form: Community Classes

Fill out the form carefully for registration
2022 New Community Member Enrollment

All families must be enrolled under an adult 18 years of age or older. Please use this form to submit your initial enrollment along with your annual registration fee.

Makeup Classes: If you miss a class, you have 30 days to make up a class at another day or time.

Class Rate:

1st community member = $5 per class

2nd community member = $10 per class

3rd community member = $15 per class

4th community member and any additional = $20 per class
Contact Information

This should be an adult and will be the main contact for your family. Please fill this form out carefully. Mistaken email addresses and phone numbers will result in miscommunication.
Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail Address

Confirmation Emailexample@example.com
Mobile Number
Format: (000) 000-0000.

Medical History/Special Needs

Please take a moment to share any unique care health concerns that may be relevant while you are here at LeBossCoDance.
Do you or any member of your family that will be enrolled at LeBossCoDance, have any pertinent medical history or allergies that we should be aware of?
(i.e., asthma, injuries, heart conditions, anaphylactic reactions, emotional/cognitive/physical disabilities)
Is there anything else you would like us to know about you or any enrolled member of your family?

Registration Form: Community Classes