2025-2026 Dance Registration Form

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Full NameName of Student
First Name
Last Name
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AgeStudents Age
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GradeStudents Grade
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Birth DateStudents Date of Birth
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AddressStudents Primary Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Parent or Guardian Name and RelationshipFirst Emergency Contact of Student
First/Last name and Relationship to student
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Phone NumberPhone Number of Parent or Guardian
Please enter a valid phone number.
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EmailParent or Guardian Email
example@example.com
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Class Choices & PricingChoose as many that your student is interested in.
Pre-K Combo Class - $60/Month
Kindergarten Combo Class - $60/month
1st Grade Combo Class - $60/Month
6th-7th Combo Class - ACRO & JAZZ - $60/Month
8th-HS Combo Class - ACRO & JAZZ - $60/Month
Level 2 TAP - Grades 4th-7th - $40/month
Level 3 TAP - Grades 6th-HS - $40/month
Level 3 Hip Hop - $40/Month
Intro to Lyrical - $40/Month
Lyrical/Contemporary - 5th-HS - $40/Month
Advanced Acro - $50/Month
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Class Specification Comment here if you need to specify taking only certain classes in a combo, spring or fall solo or duet, duet partners or any other additions you need to make. *not required, skip if you do not need to note anything.
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General Liability WaiverWAIVER AND RELEASE FROM LIABILITY FOR DANCE INSTRUCTION, OCCASION HALL RENTING and FITNESS CLASSES. I have chosen to have my child participate in dance instruction by The Studio. I acknowledge and understand the nature of the activities my child will be participating in and that my child is in the proper physical condition and capable of participating in the related activities, understanding that The Studio is not in any way responsible for making such a determination. In consideration of my child’s enrollment in any dance instruction program, I understand and agree on behalf of myself and my child, to release, hold harmless, and discharge The Studio from all claims, costs, liabilities, expenses or judgments, including attorneys’ fees and court costs for any occurrences in connection with any dance instruction. I assume all risks to my child in connection with any instruction and further release The Studio, its owners and employees from liability for any injury sustained by my child while he or she is enrolled in any dance instruction program, including all risks reasonably connected with such activity whether foreseen or unforeseen. I understand that The Studio is not responsible for my child or other children under my supervision who are left unsupervised in the common areas and areas surrounding the dance studio and that The Studio will only be supervising my child when he or she is participating in scheduled dance activities, programs or instruction. I understand that The Studio is not responsible for personal property that is lost, damaged or stolen while I or my child is at or on The Studio property. I acknowledge and agree that it is my responsibility to maintain my own accident and health insurance coverage that provides adequate coverage for myself and my child participating in The Studio activities and that The Studio does not provide accident or health insurance for those participating in its instruction, activities or programs. I authorize and agree that The Studio may take and use photographs, videos or likenesses of myself or my child as needed for its record-keeping, advertising and/or public relations projects and that I have no rights to the same and will not be compensated for the same. My signature is proof of my intention to execute a complete and unconditional waiver and release of all liability pursuant to the terms herein, and agreement as to all terms and conditions contained above. I am of lawful age and competent to sign this affirmation. Agreement of Classroom Protocol: I understand that the accepted practice and methodology of professional dance training entails “hands on” and other forms of physical contact with instructors and other students, and that this is necessary for a student to learn at an appropriate pace. I understand that if there is currently, or ever would be, any reason why I should not be touched, or should only be touched in a specific way, that it is my responsibility to inform EACH instructor as to what is acceptable, and to discuss any related physical or mental issues with them. I HAVE FULLY INFORMED MYSELF AS TO THE CONTENTS OF THIS RELEASE AND HAVE READ THE SAME PRIOR TO SIGNING.
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Social Media ContentI allow The Studio to post pictures/videos of my student on their social media accounts as deemed appropriate. This may include recital, class, holiday, birthday or ad content.
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Payment Options*REQUIRED TO HOLD YOUR SPOT
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ORDER SUMMARY
Total costUSD
Registration Fee - 1 Student
One time registration fee for one student.
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Quantity
Registration Fee - Family Pricing
One time registration fee for a family of two or more students.
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Total cost
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Payment Methods
Debit Or Credit Card
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